Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 25MA09318800 | NJ |
Y | 207YP0228X | Pediatric Otolaryngology | 25MA09318800 | NJ |
NPI | 1184820201 |
---|---|
Provider Name | Dr. Kelvin Ming-Tak Kwong |
First Address | New Brunswick, NJ 08901-2066 |
Second Address | New Brunswick, NJ 08901-2065 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 05/04/2021 |