Individual provider · Type 1 NPI

Bogum Kwon, PA

Physician Assistant · Great Neck, NY

NPI number 1710401484 Active

Practice location

833 Northern Blvd
Great Neck, NY 11021-5315

Call (516) 498-8400 Map

Mailing address

833 Northern Blvd Ste 160
Great Neck, NY 11021-5322

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Surgical Physician Assistant 363AS0400XNone listed
Physician Assistant Primary 363A00000X021238 (NY)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1710401484

Bogum Kwon, PA's National Provider Identifier is 1710401484, issued on Aug 3, 2017. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Great Neck, NY. The record was last updated on Jul 9, 2025.