Provider Demographics
NPI:1063724169
Name:TRAN, ANH VAN (OD)
Entity type:Individual
Prefix:DR
First Name:ANH
Middle Name:VAN
Last Name:TRAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 W BURNSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4018
Mailing Address - Country:US
Mailing Address - Phone:718-299-5454
Mailing Address - Fax:718-299-0770
Practice Address - Street 1:54 W BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4018
Practice Address - Country:US
Practice Address - Phone:718-299-5454
Practice Address - Fax:718-299-0770
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007585152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist