Tae S Kwon, MD

Primary specialty

Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X

License

136685 Issued in NY

Practice address

110 Wells Farm Rd
Goshen, NY 10924-6740

Phone

(845) 291-7553

Fax

(845) 291-7551

NPI assigned

May 10, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073727822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BROOKLINE WAY",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564136",
            "telephone_number": "845-634-2293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WELLS FARM RD",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109246740",
            "telephone_number": "845-291-7553",
            "fax_number": "845-291-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "TAE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NY",
            "license": "136685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Kruithof, LAC
• Liezel A Kuchinsky
• Aleksey Kuklov, M.D.
• Rebecca A Kunkel, LCSW
• Maureen Finnegan Kussard, R.N
• Gina Rose Labozzetti Brugellis, M.S. SLP TSHH
• Cristine Labush, MS, CCC-SLP
• Cynthia Ladanyi, OTR/L
• Vega Lalire, PHD
• Chloe Evelyn Lamb, MSW

• Psychosomatic Medicine Physician in Goshen, NY
• Providers in Goshen, NY by specialty
• Psychosomatic Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.