Individual
MARY THERESA TRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 SEYMOUR ST, HARTFORD, CT 06106-3315
(860) 545-5000
Mailing address
25 BIRDSEY AVE, MIDDLETOWN, CT 06457-4301
(860) 501-5557
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
6933
CT
363AS0400X
Surgical Physician Assistant
Primary
6933
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/21/2024
Last updated
01/17/2025
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