MEDICARE: JUNG H 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	207ZN0500X	Neuropathology Physician	022526	CT
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	022526	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	:	1518956937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNG H KIM MD

Provider Business Mailing Address
First Line	:	300 GEORGE ST
Second Line	:	6TH FLOOR PO BOX 9805
City	:	NEW HAVEN
State	:	CT
Zip	:	06536-0805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 CEDAR ST
Second Line	:	LAUDER HALL RM 108
City	:	NEW HAVEN
State	:	CT
Zip	:	06510-3218
Country	:	US
Telephone Number	:	203-785-2788
Fax Number	:

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	08/04/2008

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Directions to “ JUNG H KIM MD” Practice Location

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