Provider Demographics
NPI:1285659565
Name:KANG, PRITPAL S (MD)
Entity Type:Individual
Prefix:
First Name:PRITPAL
Middle Name:S
Last Name:KANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3232
Mailing Address - Country:US
Mailing Address - Phone:718-836-0600
Mailing Address - Fax:718-836-0078
Practice Address - Street 1:705 86TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3232
Practice Address - Country:US
Practice Address - Phone:718-836-0600
Practice Address - Fax:718-836-0078
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133612207UN0902X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC10385Medicare UPIN
NY49A981Medicare PIN