Provider Demographics
NPI:1487331716
Name:TAN, WEI SHEN (MD, PHD, FRCS)
Entity type:Individual
Prefix:DR
First Name:WEI SHEN
Middle Name:
Last Name:TAN
Suffix:
Gender:M
Credentials:MD, PHD, FRCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 RIDGEWOOD TER
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-1256
Mailing Address - Country:US
Mailing Address - Phone:346-509-1931
Mailing Address - Fax:
Practice Address - Street 1:YALE NEW HAVEN HOSPITAL
Practice Address - Street 2:20 YORK ST
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06520
Practice Address - Country:US
Practice Address - Phone:203-688-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT77416208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program