Basic Information
Provider Information
NPI: 1972992980
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRANG
FirstName: TRINH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 800 WESTCHESTER AVE STE N715
Address2:  
City: RYE BROOK
State: NY
PostalCode: 105731376
CountryCode: US
TelephoneNumber: 9146075730
FaxNumber: 9144571195
Practice Location
Address1: 210 WESTCHESTER AVE
Address2:  
City: WHITE PLAINS
State: NY
PostalCode: 106042901
CountryCode: US
TelephoneNumber: 9146820731
FaxNumber: 9146815289
Other Information
ProviderEnumerationDate: 01/14/2015
LastUpdateDate: 10/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
208000000X297860NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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