Provider Demographics
NPI:1548248107
Name:CHOI, KWANG N (MD)
Entity type:Individual
Prefix:DR
First Name:KWANG
Middle Name:N
Last Name:CHOI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:BOX 1262
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2056
Mailing Address - Country:US
Mailing Address - Phone:718-270-8867
Mailing Address - Fax:718-270-1794
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:RM ALL1369
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2056
Practice Address - Country:US
Practice Address - Phone:718-270-1593
Practice Address - Fax:718-270-1535
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2014-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY125613-12085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01054746Medicaid
NYC08674Medicare UPIN
NY17G431Medicare ID - Type Unspecified