MEDICARE: CORNELIO R HONG MD

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	207R00000X	Internal Medicine Physician

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	:	1780789453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNELIO R HONG MD

Provider Business Mailing Address
First Line	:	167 WASHINGTON ST
Second Line	:
City	:	NORWICH
State	:	CT
Zip	:	06360-4211
Country	:	US
Telephone Number	:	860-887-7421
Fax Number	:	860-886-6488

Provider Business Practice Location Address
First Line	:	167 WASHINGTON ST
Second Line	:
City	:	NORWICH
State	:	CT
Zip	:	06360-4211
Country	:	US
Telephone Number	:	860-887-7421
Fax Number	:	860-886-6488

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. BONNIE HONG
Credential	:
Telephone Number	:	860-887-7421

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	01/05/2012

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