MEDICARE: DR. WOO YUP KANG DC

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	111N00000X	Chiropractor	9060	NY

General Provider Information

NPI Number	:	1649234873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WOO YUP KANG DC

Provider Business Mailing Address
First Line	:	2016 GRAND AVE
Second Line	:
City	:	NORTH BALDWIN
State	:	NY
Zip	:	11510-2811
Country	:	US
Telephone Number	:	516-623-2277
Fax Number	:	516-623-2525

Provider Business Practice Location Address
First Line	:	2016 GRAND AVE
Second Line	:
City	:	NORTH BALDWIN
State	:	NY
Zip	:	11510-2811
Country	:	US
Telephone Number	:	516-623-2277
Fax Number	:	516-623-2525

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	09/15/2016

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