Eric Fan, M.d. Llc | |
200 Orchard St Suite 303 New Haven CT 06511-5363 | |
(203) 867-5600 | |
(203) 867-5604 |
Full Name | Eric Fan, M.d. Llc |
---|---|
Speciality | Internal Medicine |
Location | 200 Orchard St, New Haven, Connecticut |
Authorized Official Name and Position | Eric Fan (MANAGER) |
Authorized Official Contact | 2038675600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Eric Fan, M.d. Llc 200 Orchard St Suite 303 New Haven CT 06511-5363 Ph: (203) 867-5600 | Eric Fan, M.d. Llc 200 Orchard St Suite 303 New Haven CT 06511-5363 Ph: (203) 867-5600 |
NPI Number | 1700100781 |
---|---|
Provider Enumeration Date | 03/20/2010 |
Last Update Date | 03/20/2010 |
Medicare PECOS PAC ID | 0042341190 |
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Medicare Enrollment ID | O20100706000590 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700100781 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 038797 (Connecticut) | Primary |
Provider Name | Eric Fan |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1114966561 PECOS PAC ID: 0042345902 Enrollment ID: I20100317000278 |
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