Healthcare Provider Details

I. General information

NPI: 1831964519
Provider Name (Legal Business Name): DANA TRAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MAGUIRE RD
LEXINGTON MA
02421-3114
US

IV. Provider business mailing address

501 CONGRESS ST APT 520
BOSTON MA
02210-2920
US

V. Phone/Fax

Practice location:
  • Phone: 781-860-1700
  • Fax:
Mailing address:
  • Phone: 617-655-4750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0005X
TaxonomyNeurodevelopmental Disabilities Physician
License Number3015404
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: