Individual
MOONWHA KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P
Contact information
Practice address
845 PALMER AVE DEPT OF, MAMARONECK, NY 10543
(914) 864-5857
(914) 864-5859
Mailing address
845 PALMER AVE DEPT OF, MAMARONECK, NY 10543-2406
(914) 864-5857
(914) 864-5859
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
F305931
NY
363LG0600X
Gerontology Nurse Practitioner
Primary
F340829
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03574701
—
NY
01
—
A400150755
MEDICARE
NY
Enumeration date
09/13/2012
Last updated
10/17/2018
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