Provider Demographics
NPI:1720112352
Name:KWO, SOPHIA H (MD)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:H
Last Name:KWO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1991 MARCUS AVE STE 102
Mailing Address - Street 2:DIVISION OF PLASTIC SURGERY
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1991 MARCUS AVE STE 102
Practice Address - Street 2:DIVISION OF PLASTIC SURGERY
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-2062
Practice Address - Country:US
Practice Address - Phone:516-497-7900
Practice Address - Fax:516-497-7920
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2013-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY163708208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery