Provider Demographics
NPI:1477861391
Name:QI, HONG
Entity Type:Individual
Prefix:
First Name:HONG
Middle Name:
Last Name:QI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SANDPIPER LN
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1347
Mailing Address - Country:US
Mailing Address - Phone:860-287-3796
Mailing Address - Fax:860-691-2421
Practice Address - Street 1:26 SANDPIPER LANE
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333
Practice Address - Country:US
Practice Address - Phone:860-287-3796
Practice Address - Fax:860-691-2421
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT291171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist