Individual ProviderBo PengInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address20 York St, New Haven, CT 06510-3220(203) 688-4242(203) 932-5711PECOS EnrollmentBased on the most recent information from CMS, provider Bo Peng is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:14 PM.Profile DetailsProvider ID1003481151Provider TypeIndividualFull NamePeng, BoCredentialMDGenderMaleSole ProprietorNoEnumeration Date5/21/2021Last Updated6/25/2024Contact InformationPractice LocationPractice Address20 York St, New Haven, CT 06510-3220Phone(203) 688-4242FaxUnlisted FaxMailing LocationMailing Address950 Campbell Ave, West Haven, CT 06516-2770Phone(203) 932-5711FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense78705ConnecticutCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer