Healthcare Provider Details

I. General information

NPI: 1487865523
Provider Name (Legal Business Name): LILY HOANG TRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 YORK ST
NEW HAVEN CT
06510-3221
US

IV. Provider business mailing address

15 YORK ST
NEW HAVEN CT
06510-3221
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-5708
  • Fax: 203-737-2236
Mailing address:
  • Phone: 203-785-5708
  • Fax: 203-737-2236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA118437
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number84565
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberC1-0024191
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: