Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 274545 | MA |
N | 111NI0900X | Internist | 274545 | MA |
Y | 207RC0000X | Internist - Cardiovascular Disease | 274545 | MA |
NPI | 1023437902 |
---|---|
Provider Name | Khanh-Van Thi Tran |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01655-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 29/04/2021 |