Provider Demographics
NPI:1245284074
Name:TRAN, VINCENT P (DO)
Entity type:Individual
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First Name:VINCENT
Middle Name:P
Last Name:TRAN
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1070 HWY 34
Mailing Address - Street 2:SUITE C
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3469
Mailing Address - Country:US
Mailing Address - Phone:732-290-0300
Mailing Address - Fax:732-290-1267
Practice Address - Street 1:1070 HWY 34
Practice Address - Street 2:SUITE C
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3469
Practice Address - Country:US
Practice Address - Phone:732-290-0300
Practice Address - Fax:732-290-1267
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-09-01
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Provider Licenses
StateLicense IDTaxonomies
NJMB07739700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI50702Medicare UPIN