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Individual

MR. MOSES SEUNGHO KANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
116 W 32ND ST FL 8, NEW YORK, NY 10001-3212
(212) 564-2350
Mailing address
8340 AUSTIN ST APT 2H, KEW GARDENS, NY 11415-1827
(773) 401-8224

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
673070874
DRIVER LICENSE
NY
Enumeration date
04/05/2019
Last updated
04/05/2019
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