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Individual

DR. GINA SUE KWAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
310 E SHORE RD, 206, GREAT NECK, NY 11023-2432
(516) 487-7677
(516) 487-2868
Mailing address
310 E SHORE RD, 206, GREAT NECK, NY 11023-2432
(516) 487-7677
(516) 487-2868

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
187525
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4V2271
BC/BS
NY
Enumeration date
07/07/2005
Last updated
12/16/2009
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