MEDICARE: DR. KYUNG HWAN HONG O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	4186	MA
2	152W00000X	Optometrist	002654	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578657391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYUNG HWAN HONG O.D.

Provider Business Mailing Address
First Line	:	405 HARTFORD RD
Second Line	:
City	:	NEW BRITAIN
State	:	CT
Zip	:	06053-1507
Country	:	US
Telephone Number	:	860-893-7016
Fax Number	:	860-893-7017

Provider Business Practice Location Address
First Line	:	405 HARTFORD RD
Second Line	:
City	:	NEW BRITAIN
State	:	CT
Zip	:	06053-1507
Country	:	US
Telephone Number	:	860-893-7016
Fax Number	:	860-893-7017

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	03/17/2018

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