Individual
EDWIN KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
617 BROAD ST, NEWARK, NJ 07102-4403
(862) 246-7940
Mailing address
111 CENTRAL AVE, NEWARK, NJ 08844
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00436000
NJ
363AM0700X
Medical Physician Assistant
25MP00436000
NJ
Other
Enumeration date
05/17/2017
Last updated
12/03/2021
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