Individual
CALVIN KWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 562-0100
Mailing address
149-06 NORTHERN BLVD APT 507, FLUSHING, NY 11354
(718) 757-7666
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
665623-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
665623-01
NY
Other
Enumeration date
04/01/2020
Last updated
02/02/2022
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