Andrew Kwak, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD074005L Issued in PA

Practice address

919 Conestoga Rd
Building Two, Suite 305
Bryn Mawr, PA 19010-1352

Phone

(610) 525-0606

Fax

(610) 525-5912

NPI assigned

Jun 29, 2006

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Trustees of the University of Pennsylvania

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1124882949
  NPD (past)
• Univ of Penn Community Radiology

  • Diagnostic Radiology Physician
  • Wayne, PA
  • NPI 1740293232
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1477581569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 CONESTOGA RD",
            "address_2": "BUILDING TWO, SUITE 305",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101352",
            "telephone_number": "610-525-0606",
            "fax_number": "610-525-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 CONESTOGA RD",
            "address_2": "BUILDING TWO, SUITE 305",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101352",
            "telephone_number": "610-525-0606",
            "fax_number": "610-525-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD074005L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph William Kuncl, MD, PHD
• Mark Faisal Kurd, MD
• Shanu Kohli Kurd, MD
• Flora Yau Kurtz, D.O.
• Jillian Kurtz
• Diane M. Lagomarsino, CRNP
• Cheryl A Laing, EFDA
• Tara Lal
• Amber Brooke Lallo, PA
• Quynhdiem Thi Lam

• Diagnostic Radiology Physician in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.