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Organization

CHARLES C. KWAK, MD, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES C KWAK M.D. (PROPRIETOR)
(718) 460-1639
Entity
Organization

Contact information

Practice address
3420 PARSONS BLVD, LF, FLUSHING, NY 11354-4622
(718) 460-1639
Mailing address
3420 PARSONS BLVD, LF, FLUSHING, NY 11354-4622

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
218069
NY

Other

Enumeration date
01/12/2012
Last updated
01/12/2012
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