Kyu S Wang MD PC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

25MA04592900 Issued in NJ

Legal business name

KYU S WANG MD PC

Practice address

1033 Palisade Ave
Fort Lee, NJ 07024-6320

Phone

(201) 224-6800

Fax

(201) 224-6804

NPI assigned

Sep 8, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kyu S Wang, MDNPI 1518037340

Title

President

Phone

(201) 224-6800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyu Sung Wang, MD

  • Nephrology Physician
  • Fort Lee, NJ
  • NPI 1518037340
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1407137060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246320",
            "telephone_number": "201-224-6800",
            "fax_number": "201-224-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246320",
            "telephone_number": "201-224-6800",
            "fax_number": "201-224-6804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYU S WANG MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "KYU",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-224-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA04592900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geeta Kumar, DO
• Grace Kuo, M.D.
• Moonju Kwak, RN
• Kwon Podiatry NJ PC
• Jihae Kwon, D.D.S
• Thomas Labocki, D.P.T.
• Laconia Foot Surgeons PC
• Lactation House Calls, LLC
• Jonathan Lam, PHARMD
• Michael Lam, MD

• Nephrology Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.