Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 010439 | CT |
Y | 213EG0000X | General Practice | 010439 | CT |
NPI | 1003109851 |
---|---|
Provider Name | Dr. Sueyoung Chi |
First Address | Manchester, CT 06042 |
Second Address | Manchester, CT 06042-8785 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2011 |
Last Update Date | 17/03/2018 |