Chengmo Bao

NPI #1760845952 in Glen Cove, New York

Provider Information

NPI Number: 1760845952
Entity Type: Individual
Name: Chengmo Bao
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Apr 4, 2016
Last Updated: Apr 4, 2016

Practice Location

Address: 12 SYCAMORE RD
City: Glen Cove
State: New York
ZIP Code: 11542-1725
Phone: (347) 721-0271

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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