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General NPI Number Information
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NPI Number | 1508465840
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Entity Type | Individual
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Provider Name | TRAN TRAN BROUGH PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 417 BALTIMORE PIKE
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City | SPRINGFIELD
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State | PA
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Zip | 19064-3810
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Country | US
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Telephone | 484-470-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 COX RD
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City | GLEN ALLEN
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State | VA
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Zip | 23060-9263
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Country | US
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Telephone | 804-968-5700
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00606600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | OA005408
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA062043
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License Number State | PA
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