Provider Demographics
NPI:1225298722
Name:KWON, ALBERT O (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:O
Last Name:KWON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1124 E RIDGEWOOD AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3941
Mailing Address - Country:US
Mailing Address - Phone:201-689-9100
Mailing Address - Fax:201-689-9108
Practice Address - Street 1:1124 E RIDGEWOOD AVE STE 202
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3941
Practice Address - Country:US
Practice Address - Phone:201-689-9100
Practice Address - Fax:201-689-9108
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08887800208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery