Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 009652 | CT |
N | 1223P0700X | Prosthodontist | 048520-1 | NY |
NPI | 1003809773 |
---|---|
Provider Name | Dr. Yaohsien Peng |
First Address | Uncasville, CT 06382-1208 |
Second Address | Uncasville, CT 06382-1208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 21/08/2013 |