Individual
JACQUELYN KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 584-4040
Mailing address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 584-4040
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
217113
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2018675
—
MA
Enumeration date
09/13/2005
Last updated
05/28/2024
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