Provider Demographics
NPI:1578264826
Name:TRAHAN, MARIE-JULIE AUDREY (MD)
Entity Type:Individual
Prefix:
First Name:MARIE-JULIE
Middle Name:AUDREY
Last Name:TRAHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 METCALFE AVENUE
Mailing Address - Street 2:APT. 210
Mailing Address - City:WESTMOUNT
Mailing Address - State:QC
Mailing Address - Zip Code:H32 2H5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:622 WEST 168TH STREET
Practice Address - Street 2:COLUMBIA UNIVERSITY IRVING MEDICAL CENTER, DEPARTMENT O
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:631-626-8097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program