Basic Information
| Provider Information | |||||||||
| NPI: | 1528076809 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TIEN | ||||||||
| FirstName: | JAN | ||||||||
| MiddleName: | JY-YEAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 HICKORY DR | ||||||||
| Address2: | |||||||||
| City: | BASKING RIDGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079201951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9086470180 | ||||||||
| FaxNumber: | 9086045359 | ||||||||
| Practice Location | |||||||||
| Address1: | 151 KNOLLCROFT RD | ||||||||
| Address2: | PHARMACY 119 | ||||||||
| City: | LYONS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079395001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9086470180 | ||||||||
| FaxNumber: | 9086045359 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P1300X | 035072-1 | NY | N | Pharmacy Service Providers | Pharmacist | Psychiatric | 1835P1300X | 28RI01796900 | NJ | Y | Pharmacy Service Providers | Pharmacist | Psychiatric |
No ID Information.