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General NPI Number Information
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NPI Number | 1699448043
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Entity Type | Individual
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Provider Name | DARRIEN PHILLIP TRAN FNP
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Gender | Male
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 08/14/2021
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Provider Practice Location Address
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Address Line | 75 W RED BANK AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-1694
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Country | US
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Telephone | 856-863-5720
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Fax |
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Provider Business Mailing Address
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Address Line | 160 ELM AVE
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City | WOODLYNNE
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State | NJ
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Zip | 08107-2250
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Country | US
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Telephone | 609-560-7085
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ01162500
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License Number State | NJ
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