Jae Kang
Psychiatry & Neurology, Psychiatry in Medford, NY. Individual provider (NPI-1).
NPI number1700902145
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1700902145
- Entity type
- Individual (NPI-1)
- Name
- Jae Kang
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2007
- Last updated
- Mar 7, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | 120115 | NY | Yes |
Practice location
1727 N Ocean AveMedford, NY 11763-2649
Phone 631-654-1919
Mailing address
184 Montecito CresMelville, NY 11747-5210
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 6 Psychiatry Physician providers in Medford · All 733 providers in Medford
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