MEDICARE: AMI P KANG LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC05761100	NJ

General Provider Information

NPI Number	:	1225542434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMI P KANG LCSW

Provider Business Mailing Address
First Line	:	80 RIVER ST STE 302
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-5619
Country	:	US
Telephone Number	:	732-266-4837
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 RIVER ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-5626
Country	:	US
Telephone Number	:	732-227-0070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2017
Last Update Date	:	09/22/2020

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Directions to “ AMI P KANG LCSW” Practice Location

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