Individual
JEONG EUN OH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4 GROVE BEACH RD N, BLDG1, UNIT A, WESTBROOK, CT 06498-1656
(860) 664-3553
(860) 358-8656
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-4820
(860) 358-6748
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
046567
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008001633
—
CT
Enumeration date
01/22/2008
Last updated
05/04/2012
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