Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 159675 | MA |
NPI | 1043205974 |
---|---|
Provider Name | Dr. Cathy D Chong |
First Address | Weymouth, MA 02190-1659 |
Second Address | Weymouth, MA 02190-1659 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 07/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3195686 | (05) | MA |
G92902 | (02) | MA |