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General NPI Number Information
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NPI Number | 1578562054
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Entity Type | Individual
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Provider Name | HONG T-L RAPHAEL MD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 380 GUY PARK AVE ST. MARY'S HOSPITAL, FAM HLTH CNTR @ CARONDELET PAVILIO
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City | AMSTERDAM
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State | NY
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Zip | 12010-1055
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Country | US
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Telephone | 518-841-7415
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Fax | 518-841-7422
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Provider Business Mailing Address
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Address Line | 427 GUY PARK AVE - PRIMARY & SPECIALTY CARE DEPT. ST. MARY'S HOSPITAL @ AMSTERDAM
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City | AMSTERDAM
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State | NY
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Zip | 12010
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Country | US
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Telephone | 518-841-7430
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Fax | 518-841-7121
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 183386-1
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License Number State | NY
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