Provider Demographics
NPI:1508976127
Name:HWANG, YONGKYU (MD)
Entity Type:Individual
Prefix:
First Name:YONGKYU
Middle Name:
Last Name:HWANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142-04 BAYSIDE AVE
Mailing Address - Street 2:#3U
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:718-353-6200
Mailing Address - Fax:718-445-5847
Practice Address - Street 1:142-04 BAYSIDE AVE
Practice Address - Street 2:#3U
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354
Practice Address - Country:US
Practice Address - Phone:718-353-6200
Practice Address - Fax:718-445-5847
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144832207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
82523Medicare ID - Type Unspecified
B81794Medicare UPIN