Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Charles C Kwak, MD

Individual provider Dermatology Physician · NPI 1548270218

Dr. Charles C Kwak, MD is a Dermatology in Elmhurst, New York. Graduated from State University of Ny Upstate Medical University in 1998, 28 years ago. Practices with Premier Healthcare Inc, a 59-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
28
Trained at
State University of Ny Upstate Medical University
Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4012 80th St
Elmhurst, NY 11373-1234
Phone: (718) 886-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2 Centerock Rd, West Nyack, NY 10994-2215 — (845) 703-6999

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 218069 (NY)

Record details

NPI number1548270218
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 8, 2006
Last updated in NPPESAugust 31, 2021
Certification dateAugust 31, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolSTATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduated 1998 (28 years in practice)
Group practice Premier Healthcare Inc — 59 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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