Healthcare Provider Details

I. General information

NPI: 1407874100
Provider Name (Legal Business Name): RICHARD KANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 STUYVESANT AVE
LYNDHURST NJ
07071-1833
US

IV. Provider business mailing address

PO BOX 1825
FORT LEE NJ
07024-1218
US

V. Phone/Fax

Practice location:
  • Phone: 201-729-0001
  • Fax: 201-729-0006
Mailing address:
  • Phone: 201-729-0001
  • Fax: 201-729-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number25MA08064200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: