Individual
DR. NANCY KWON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
33 RESEARCH WAY, EAST SETAUKET, NY 11733-3489
(631) 444-4090
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-4090
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T005664
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02139619
—
NY
01
—
7381201
AETNA
NY
01
—
C008J1
EMPIRE BC.BS
NY
Enumeration date
06/23/2006
Last updated
11/13/2012
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