Provider Demographics
NPI:1245510445
Name:HONG, GRACE HWANG (APRN)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:HWANG
Last Name:HONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:CHOI
Other - Last Name:HWANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:282 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106
Mailing Address - Country:US
Mailing Address - Phone:293-298-0414
Mailing Address - Fax:
Practice Address - Street 1:282 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:203-330-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4754363LP0200X
CT12.004754363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics