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General NPI Number Information
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NPI Number | 1184820201
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Entity Type | Individual
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Provider Name | KELVIN MING-TAK KWONG M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 10 PLUM ST 8TH FLOOR
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2065
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Country | US
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Telephone | 732-235-5530
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Fax |
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Provider Business Mailing Address
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Address Line | 10 PLUM ST FL 8
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2066
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Country | US
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Telephone | 732-235-5530
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Fax | 732-235-7220
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 25MA09318800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number | 25MA09318800
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License Number State | NJ
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