Provider Demographics
NPI:1386248649
Name:TRAN, LILY
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LILY
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1717 N 12TH ST UNIT F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-2585
Mailing Address - Country:US
Mailing Address - Phone:215-235-2001
Mailing Address - Fax:267-744-4493
Practice Address - Street 1:1717 N 12TH ST UNIT F
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19122-2585
Practice Address - Country:US
Practice Address - Phone:215-235-2001
Practice Address - Fax:267-744-4493
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist