# KWON PODIATRY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780310003
- **Authorized official:** DR. JAKE S KWON DPM (DOCTOR)
- **Authorized official phone:** (917) 923-7735

## Contact information

- **Practice address:** 4232 FRANCIS LEWIS BLVD, BAYSIDE, NY 11361-2561
- **Practice address phone:** (646) 389-6485
- **Mailing address:** 81 PILGRIM LN, WESTBURY, NY 11590-6218

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 07/28/2022
- **Last updated:** 03/05/2026