Provider Demographics
NPI:1891247888
Name:KUANG, KEVIN
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:KUANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 FULTON ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2636
Mailing Address - Country:US
Mailing Address - Phone:718-852-5470
Mailing Address - Fax:
Practice Address - Street 1:1360 FULTON ST
Practice Address - Street 2:SUITE 502
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-2636
Practice Address - Country:US
Practice Address - Phone:718-852-5470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator