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General NPI Number Information
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NPI Number | 1063519973
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Entity Type | Individual
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Provider Name | PAUL CU TRAN D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 136 BROADWAY STE 3
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City | SARANAC LAKE
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State | NY
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Zip | 12983-1404
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Country | US
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Telephone | 518-891-9161
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Fax | 518-891-9187
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Provider Business Mailing Address
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Address Line | PO BOX 1239
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City | SARANAC LAKE
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State | NY
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Zip | 12983-7239
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Country | US
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Telephone | 518-891-9161
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Fax | 518-891-9187
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 005721
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License Number State | NY
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