Healthcare Provider Details

I. General information

NPI: 1992907505
Provider Name (Legal Business Name): ELLEN HSU-HUNG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 LINCOLN ST METROWEST MEDICAL CENTER
FRAMINGHAM MA
01702-6358
US

IV. Provider business mailing address

115 LINCOLN ST METROWEST MEDICAL CENTER
FRAMINGHAM MA
01702-6358
US

V. Phone/Fax

Practice location:
  • Phone: 508-383-1104
  • Fax: 508-383-1138
Mailing address:
  • Phone: 508-383-1104
  • Fax: 508-383-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberLP01139
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number248897
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: