Provider Demographics
NPI:1962716548
Name:TRAN, LONG NGOC (PHARMD)
Entity type:Individual
Prefix:
First Name:LONG
Middle Name:NGOC
Last Name:TRAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 TERRY PKWY
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2795
Mailing Address - Country:US
Mailing Address - Phone:504-364-5722
Mailing Address - Fax:504-364-0367
Practice Address - Street 1:497 TERRY PKWY
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-2795
Practice Address - Country:US
Practice Address - Phone:504-364-5722
Practice Address - Fax:504-364-0367
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist