Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 221683 | MA |
NPI | 1013131705 |
---|---|
Provider Name | Dr. Steve K Kwak |
First Address | Teaneck, NJ 07666-3144 |
Second Address | Teaneck, NJ 07666-3144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 09/01/2012 |