Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | VT |
NPI | 1053494377 |
---|---|
Provider Name | Richard Hong |
First Address | Charlotte, VT 05445-9354 |
Second Address | Burlington, VT 05401-3338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01346381 | (05) | NY |
0VN0383 | (05) | VT |
B53686 | (02) |