Individual
JEFFREY KWONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
314 W 14TH ST, 5TH FLOOR, NEW YORK, NY 10014-5002
(212) 620-0144
(212) 691-8588
Mailing address
314 W 14TH ST, 5TH FLOOR, NEW YORK, NY 10014-5002
(212) 620-0144
(212) 691-8588
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
179718
CO
363LA2200X
Adult Health Nurse Practitioner
Primary
F305366-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61429716
—
CO
Enumeration date
01/09/2007
Last updated
04/01/2011
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