Individual
MARY KWON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1 GUSTAVE LEVY PL., MT. SINAI MEDICAL CENTER, NEW YORK, NY 10029
(212) 241-6500
Mailing address
2945 214TH PL, BAYSIDE, NY 11360-2804
(917) 617-0832
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
013564
NY
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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