Healthcare Provider Details

I. General information

NPI: 1104243229
Provider Name (Legal Business Name): KEVIN KWAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 MAIN ST STE 3
BEDMINSTER NJ
07921-2689
US

IV. Provider business mailing address

350 MAIN ST STE 3
BEDMINSTER NJ
07921-2689
US

V. Phone/Fax

Practice location:
  • Phone: 908-888-9398
  • Fax: 917-267-5902
Mailing address:
  • Phone: 908-888-9398
  • Fax: 917-267-5902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number25MA11015300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: