Healthcare Provider Details

I. General information

NPI: 1730795238
Provider Name (Legal Business Name): EUN CHUNG HONG FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2020
Last Update Date: 12/02/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 CHIEF JUSTICE CUSHING HWY STE 301
COHASSET MA
02025-1391
US

IV. Provider business mailing address

223 CHIEF JUSTICE CUSHING HWY
COHASSET MA
02025-1391
US

V. Phone/Fax

Practice location:
  • Phone: 781-383-6261
  • Fax: 781-383-1084
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2329745
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: