Provider Demographics
NPI:1538218276
Name:TRAN, LE VAN (DC)
Entity type:Individual
Prefix:DR
First Name:LE
Middle Name:VAN
Last Name:TRAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1317 BOUND BROOK RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLESEX
Mailing Address - State:NJ
Mailing Address - Zip Code:08846-1945
Mailing Address - Country:US
Mailing Address - Phone:732-748-9944
Mailing Address - Fax:732-748-0800
Practice Address - Street 1:520 BERGEN AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2507
Practice Address - Country:US
Practice Address - Phone:201-706-2244
Practice Address - Fax:201-706-2376
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00612200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
110723SQKMedicare UPIN