Individual
LINH MY TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1800 TREE LN STE 250, SNELLVILLE, GA 30078-6799
(770) 736-6300
Mailing address
1065 SOUTHERN BLVD, BRONX, NY 10459-2417
(718) 589-2440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
026736
NY
363A00000X
Physician Assistant
Primary
11173
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026736
STATE LICENSE
NY
01
—
1183749
NCCPA
—
Enumeration date
06/03/2021
Last updated
11/15/2023
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