Provider Demographics
NPI:1063519973
Name:TRAN, PAUL CU (DPM)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:CU
Last Name:TRAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-7239
Mailing Address - Country:US
Mailing Address - Phone:518-891-9161
Mailing Address - Fax:518-891-9187
Practice Address - Street 1:136 BROADWAY STE 3
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-1404
Practice Address - Country:US
Practice Address - Phone:518-891-9161
Practice Address - Fax:518-891-9187
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY005721213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU83350Medicare UPIN