MEDICARE: YOUNG CHOI KIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	111947	NY
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	035799	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245212596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOUNG CHOI KIM MD

Provider Business Mailing Address
First Line	:	300 GEORGE ST
Second Line	:	PO BOX 9805
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-6624
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	267 GRANT ST
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-2805
Country	:	US
Telephone Number	:	203-384-3157
Fax Number	:	203-384-3237

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	07/13/2023

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Directions to “ YOUNG CHOI KIM MD” Practice Location

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