Most Relevant Information
Provider Data
| NPI Number: | 1003481151 |
| Provider Name: | BO PENG MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/21/2021 |
| Last Updated: | 06/25/2024 |
Provider Practice Location
20 YORK ST
NEW HAVEN
CT
065103220
Practice Location Phone/Fax
| Phone: | 2036884242 |
| Fax: |
Provider Mailing Location
950 CAMPBELL AVE
WEST HAVEN
CT
065162770
Provider Mailing Phone/Fax
| Phone: | 2039325711 |
| Fax: |