Provider Demographics
NPI:1457392482
Name:TRAN, VU Q (MD)
Entity type:Individual
Prefix:
First Name:VU
Middle Name:Q
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 LONG POND RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-4057
Mailing Address - Country:US
Mailing Address - Phone:585-247-8460
Mailing Address - Fax:585-247-8462
Practice Address - Street 1:1770 LONG POND RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-4057
Practice Address - Country:US
Practice Address - Phone:585-247-8460
Practice Address - Fax:585-247-8462
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222275207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02315819Medicaid
7037477OtherAETNA
P010222275OtherBLUE SHIELD
110541BFOtherPREFERRED CARE
000920286001OtherHEALTH NOW
222275OWCFPOtherWORKERS COMP
P010222275OtherEXCELLUS PLANS
5996867OtherGHI
NY02315819Medicaid
P010222275OtherEXCELLUS PLANS