Healthcare Provider Details

I. General information

NPI: 1760418859
Provider Name (Legal Business Name): KIMAN STEPHEN HWANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 MAIN ST
FLUSHING NY
11355-5045
US

IV. Provider business mailing address

575 LEXINGTON AVE
NEW YORK NY
10022-6102
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-1435
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number200590
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: