Provider Demographics
NPI:1386156800
Name:HWANG, KRISTEN DENG
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:DENG
Last Name:HWANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13618 MAPLE AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4244
Mailing Address - Country:US
Mailing Address - Phone:718-799-0668
Mailing Address - Fax:718-799-0669
Practice Address - Street 1:13618 MAPLE AVE UNIT B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4244
Practice Address - Country:US
Practice Address - Phone:718-799-0668
Practice Address - Fax:718-799-0669
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0014093183500000X
NY065376183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist