Healthcare Provider Details

I. General information

NPI: 1508786401
Provider Name (Legal Business Name): ANH MINH TRAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 HAYES ROAD
BUFFALO NY
14214-8033
US

IV. Provider business mailing address

160 HAYES ROAD 285 PHARMACY BUILDING
BUFFALO NY
14214-8033
US

V. Phone/Fax

Practice location:
  • Phone: 716-645-2823
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number104762I
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: