Provider Demographics
NPI:1053546457
Name:TRIEU, LINH TU (OD)
Entity type:Individual
Prefix:DR
First Name:LINH
Middle Name:TU
Last Name:TRIEU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3807
Mailing Address - Country:US
Mailing Address - Phone:781-393-5700
Mailing Address - Fax:508-655-4370
Practice Address - Street 1:21 HIGH ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3807
Practice Address - Country:US
Practice Address - Phone:781-393-5700
Practice Address - Fax:508-655-4370
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4621152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist