Provider Demographics
NPI:1669721882
Name:HWANG, HYUN KWAN (LAC)
Entity type:Individual
Prefix:
First Name:HYUN
Middle Name:KWAN
Last Name:HWANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-1705
Mailing Address - Country:US
Mailing Address - Phone:646-665-2010
Mailing Address - Fax:
Practice Address - Street 1:31 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-1705
Practice Address - Country:US
Practice Address - Phone:646-665-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14736171100000X
NY005694171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist