Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 279509 | MA |
NPI | 1003311143 |
---|---|
Provider Name | Emily Weng |
First Address | Farmington, CT 06030-8074 |
Second Address | Farmington, CT 06030-8074 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2018 |
Last Update Date | 05/07/2021 |