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General NPI Number Information
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NPI Number | 1437737772
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Entity Type | Individual
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Provider Name | KIM TRAN
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Gender | Female
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 325 BOSTON POST RD STE 2F
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City | ORANGE
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State | CT
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Zip | 06477-3504
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Country | US
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Telephone | 203-795-3354
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Fax |
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Provider Business Mailing Address
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Address Line | 1016 N HIGH ST
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City | EAST HAVEN
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State | CT
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Zip | 06512-1158
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Country | US
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Telephone | 203-535-3253
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 79535
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License Number State | CT
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