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Individual

LONG TRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
830 HARRISON AVENUE, MOAKLEY, SUITE 3400, BOSTON, MA 02118
(617) 414-8060
(617) 414-8012
Mailing address
801 ALBANY STREET, FL GROUND, BOSTON, MA 02119

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7349
MA
363A00000X
Physician Assistant

Other

Enumeration date
10/16/2019
Last updated
08/31/2021
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