MEDICARE: DR. ANDREW MICHAEL KWONG PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	069010	NY

General Provider Information

NPI Number	:	1457097925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW MICHAEL KWONG PHARMD

Provider Business Mailing Address
First Line	:	11201 QUEENS BLVD APT 9J
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-5589
Country	:	US
Telephone Number	:	732-589-0118
Fax Number	:

Provider Business Practice Location Address
First Line	:	11201 QUEENS BLVD APT 9J
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-5589
Country	:	US
Telephone Number	:	732-589-0118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2022
Last Update Date	:	06/14/2024

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