Individual
DR. KI SOO HWANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
504 VALLEY RD, 2ND FLOOR, WAYNE, NJ 07470-3534
(973) 686-0700
(973) 686-0701
Mailing address
504 VALLEY RD, 2ND FLOOR, WAYNE, NJ 07470-3534
(973) 686-0700
(973) 686-0701
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
240401
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240401
NYS MEDICAL LICENSE
NY
01
—
25MA08144900
NJ STATE MEDICAL LICENSE
NJ
Enumeration date
08/09/2006
Last updated
09/18/2015
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