MEDICARE: KWON CHIROPRACTIC P.C.

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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1891643664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KWON CHIROPRACTIC P.C.

Provider Business Mailing Address
First Line	:	99-113 NY-303
Second Line	:	SUITE 207
City	:	TAPPAN
State	:	NY
Zip	:	10983
Country	:	US
Telephone Number	:	201-983-7963
Fax Number	:	914-685-6720

Provider Business Practice Location Address
First Line	:	99-113 NY-303
Second Line	:	SUITE 207
City	:	TAPPAN
State	:	NY
Zip	:	10983
Country	:	US
Telephone Number	:	201-983-7963
Fax Number	:	914-685-6720

Authorized Official
Title or Position	:	CHIROPRACTIC
Name	:	SO Y KWON
Credential	:	DC
Telephone Number	:	201-983-7963

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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