Provider Demographics
NPI:1730340118
Name:KANG, RICHARD T (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:T
Last Name:KANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 ROUTE 46
Mailing Address - Street 2:SUITE G5
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2451
Mailing Address - Country:US
Mailing Address - Phone:973-928-5363
Mailing Address - Fax:973-928-5359
Practice Address - Street 1:1037 ROUTE 46
Practice Address - Street 2:SUITE G5
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2451
Practice Address - Country:US
Practice Address - Phone:973-928-5363
Practice Address - Fax:973-928-5359
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08453100208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine