Provider Demographics
NPI:1669566329
Name:KANG, HYE-YONG (MD)
Entity type:Individual
Prefix:
First Name:HYE-YONG
Middle Name:
Last Name:KANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BROMPTON RD.
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-3447
Mailing Address - Country:US
Mailing Address - Phone:516-515-1558
Mailing Address - Fax:
Practice Address - Street 1:1399 FRANKLIN AVE. #303
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3447
Practice Address - Country:US
Practice Address - Phone:516-515-1558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246239208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A795910Medicaid
CAI25420Medicare UPIN