Provider Demographics
NPI:1720371818
Name:TRAN, TIMOTHY (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 208058
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8058
Mailing Address - Country:US
Mailing Address - Phone:203-737-7652
Mailing Address - Fax:203-785-4043
Practice Address - Street 1:365 MONTAUK AVENUE
Practice Address - Street 2:FAIRE HARBOUR BUILDING, 2ND FL, SUITE 2.013
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320
Practice Address - Country:US
Practice Address - Phone:844-817-9171
Practice Address - Fax:203-737-8035
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2018-12-19
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Provider Licenses
StateLicense IDTaxonomies
RIMD15933208800000X
CT62171208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology