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NPI Code Detail

MEDICARE: DR. SONIA KIM M.D.

MEDICARE: DR. SONIA KIM M.D.
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
1207V00000XObstetrics & Gynecology PhysicianL1359426MI
2207V00000XObstetrics & Gynecology Physician25MA09197100NJ

General Provider Information

NPI Number : 1558525840
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SONIA KIM M.D.
Provider Business Mailing Address
First Line : PO BOX 419430
Second Line :
City : BOSTON
State : MA
Zip : 02241-9430
Country : US
Telephone Number : 201-666-9300
Fax Number : 201-261-0505
Provider Business Practice Location Address
First Line : 125 WASHINGTON AVE
Second Line :
City : DUMONT
State : NJ
Zip : 07628-3066
Country : US
Telephone Number : 201-374-2722
Fax Number : 201-374-2723
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2008
Last Update Date : 04/25/2017

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