Healthcare Provider Details

I. General information

NPI: 1396271359
Provider Name (Legal Business Name): BCT COMPREHENSIVE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 HARTFORD DR
NUTLEY NJ
07110-3948
US

IV. Provider business mailing address

590 HARTFORD DR
NUTLEY NJ
07110-3948
US

V. Phone/Fax

Practice location:
  • Phone: 732-718-3165
  • Fax:
Mailing address:
  • Phone: 732-718-3165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BAO CHAU MINH TRAN
Title or Position: OWNER
Credential: MD
Phone: 732-718-3165