Look up the most recent NPI and PECOS records

Young Jay Kwak

Internal Medicine

Allopathic & Osteopathic Physicians

300 Kensington Ave, New Britain, CT 06051

PECOS Enrollment

This provider is enrolled in PECOS as YOUNG KWAK.

Based on the most recent information from CMS, provider Young Jay Kwak is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 2:56 PM.

Profile Details

Provider ID
1407182249
Provider Type
Individual
Full Name
Kwak, Young Jay
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
10/29/2009
Last Updated
5/14/2018

Contact Information

Practice Location

300 Kensington Ave, New Britain, CT 06051

(860) 832-8150

(860) 224-6298

Mailing Location

2110 Silas Deane Hwy, Rocky Hill, CT 06067-2313

(860) 832-8150

(860) 224-6298

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 051419 Connecticut
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License 051419 Connecticut
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Young Jay Kwak

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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