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General NPI Number Information
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NPI Number | 1326435116
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Entity Type | Individual
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Provider Name | CHI KONG POON
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Gender | Male
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 80 SEYMOUR ST
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City | HARTFORD
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State | CT
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Zip | 06102
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Country | US
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Telephone | 860-679-4988
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Fax |
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Provider Business Mailing Address
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Address Line | 80 SEYMOUR ST
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City | HARTFORD
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State | CT
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Zip | 06102-5307
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Country | US
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Telephone | 860-679-4988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A155310
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License Number State | CA
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