Provider Demographics
NPI:1649224676
Name:FENG, HONGHUI (MD)
Entity Type:Individual
Prefix:
First Name:HONGHUI
Middle Name:
Last Name:FENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 THOMAS WAITE RD
Mailing Address - Street 2:
Mailing Address - City:OLD LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06371-1546
Mailing Address - Country:US
Mailing Address - Phone:860-514-2873
Mailing Address - Fax:203-923-1010
Practice Address - Street 1:929 BOSTON POST RD STE 7
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-2143
Practice Address - Country:US
Practice Address - Phone:860-514-2873
Practice Address - Fax:203-923-1010
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039753207L00000X, 207LP2900X, 208VP0000X
MA158535207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001397539Medicaid
MA110062667AMedicaid
050081948OtherRAILROAD MEDICARE
050081948OtherRAILROAD MEDICARE