Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 25MA07306900 | NJ |
N | 207P00000X | Emergency Physician | 35304 | CT |
N | 208000000X | Pediatrician | 35304 | CT |
N | 2080P0204X | Pediatric Emergency Doctor | 25MA073069 | NJ |
N | 2080P0204X | Pediatric Emergency Doctor | 35304 | CT |
NPI | 1275592545 |
---|---|
Provider Name | Dr. Lielie Hong |
First Address | Paramus, NJ 07652-4131 |
Second Address | Paramus, NJ 07652-4131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 25/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
164306 | MEDICARE PTAN -NJ (01) | NJ |
D400003312 | MEDICARE IDENTIFICATION NUMBER -FRANKLIN MEDICAL GROUP (01) | CT |
H10646 | (02) | NJ |