Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 062154 | CT |
NPI | 1033520556 |
---|---|
Provider Name | Hao Feng |
First Address | Farmington, CT 06030-8082 |
Second Address | Farmington, CT 06030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2014 |
Last Update Date | 05/09/2019 |