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1710401484
BOGUM KWON
NEW HYDE PARK, NY
NPI
1710401484
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Additional Taxonomies
363AS0400X Physician Assistant, Surgical
Enumeration Date
2017-08-03
Last Update Date
2017-08-03
Business Address
BOGUM KWON
1991 MARCUS AVE STE 102
NEW HYDE PARK, NY 11042-2062
Phone number: 516-497-7900
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Mailing Address
BOGUM KWON
190-19C 71ST CRESCENT APT 1A
FRESH MEADOWS, NY 11365
Phone number: 347-287-5423
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