Healthcare Provider Details

I. General information

NPI: 1861554495
Provider Name (Legal Business Name): CALVIN HWANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 MAIN ST DEPT OF
FLUSHING NY
11355-5045
US

IV. Provider business mailing address

56-45 MAIN STREET DEPT. OF MEDICINE, 5 SOUTH
QUEENS NY
11355
US

V. Phone/Fax

Practice location:
  • Phone: 718-912-0632
  • Fax:
Mailing address:
  • Phone: 718-912-0632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number236985
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number236985
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: