Provider Demographics
NPI:1184864001
Name:CHONG, KWOK KUEN
Entity type:Individual
Prefix:
First Name:KWOK
Middle Name:KUEN
Last Name:CHONG
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 1:2 PARK AVE
Mailing Address - Street 2:IRMAT PHARMACY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5675
Mailing Address - Country:US
Mailing Address - Phone:212-685-0500
Mailing Address - Fax:
Practice Address - Street 1:2 PARK AVE
Practice Address - Street 2:IRMAT PHARMACY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5675
Practice Address - Country:US
Practice Address - Phone:212-685-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist