Individual
MR. TRIAN JOHN JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
760 BROADWAY, BROOKLYN, NY 11206-5317
(718) 963-5951
(718) 963-6893
Mailing address
1642 E 23RD ST, BROOKLYN, NY 11229-1519
(718) 975-1957
(718) 963-6893
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006020
NY
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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