Provider Demographics
NPI:1376544510
Name:KUANG, LIREN (MD)
Entity Type:Individual
Prefix:
First Name:LIREN
Middle Name:
Last Name:KUANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:835 61ST ST
Mailing Address - Street 2:UNIT 101-102
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4312
Mailing Address - Country:US
Mailing Address - Phone:718-686-0895
Mailing Address - Fax:347-715-3532
Practice Address - Street 1:835 61ST ST
Practice Address - Street 2:UNIT 101-102
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4312
Practice Address - Country:US
Practice Address - Phone:718-686-0895
Practice Address - Fax:347-715-3532
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2019-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY233541207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02621612Medicaid
NY02621612Medicaid
NYI21093Medicare UPIN