Provider Demographics
NPI:1700225083
Name:TRIANA, CARLOS (DVM)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:TRIANA
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:
Other - Last Name:TRIANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DVM
Mailing Address - Street 1:3130 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-2425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3130 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2425
Practice Address - Country:US
Practice Address - Phone:201-392-9200
Practice Address - Fax:201-863-2040
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29VI00494500174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian