Individual Healthcare Provider
Marissa Luan Tan, DO, MPH
Provider's NPPES record last updated: June 19, 2024
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1720583818
- Primary Specialty
- Preventive Medicine — Addiction Medicine
- Practice Location
- Camden, New Jersey
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 12:32 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Preventive Medicine
Addiction Medicine
Allopathic & Osteopathic Physicians
A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.
Taxonomy code 2083A0300X Preventive Medicine
Public Health & General Preventive Medicine
Allopathic & Osteopathic Physicians
Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings.
Taxonomy code 2083P0901X
Provider-Reported License Information
- Preventive Medicine (Pennsylvania)
- OS020328
- Preventive Medicine (Maryland)
- H0087983
- Preventive Medicine (New Jersey)
- 25MB12089100
- Preventive Medicine (New Jersey)
- 25MB12089100
- Preventive Medicine (Maryland)
- H0087983
- Preventive Medicine (Pennsylvania)
- OS020328
Practice Locations
Practice Location
800 Cooper St Ste 4004th
Camden, New Jersey 08102-1155
Phone: (856) 342-3040
Additional Practice Location
504 South St
Philadelphia, Pennsylvania 19147-2210
Phone: (800) 805-6989
Additional Practice Location
2317 E Westmoreland St
Philadelphia, Pennsylvania 19134-4529
Phone: (800) 805-6989
Additional Practice Location
323 S 60th St
Philadelphia, Pennsylvania 19143-1148
Phone: (800) 805-6989
Record Information
- Enumeration Date
- March 29, 2018
- Provider's NPPES Record Last Updated
- June 19, 2024
- Certification Date
- June 19, 2024
- NPISignal NPPES Dataset
- August 2026
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