Healthcare Provider Details

I. General information

NPI: 1518082213
Provider Name (Legal Business Name): STEVE Y. KIM M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 SYLVAN AVE SUITE #26
ENGLEWOOD CLIFFS NJ
07632-2726
US

IV. Provider business mailing address

385 SYLVAN AVE SUITE #26
ENGLEWOOD CLIFFS NJ
07632-2726
US

V. Phone/Fax

Practice location:
  • Phone: 201-569-9130
  • Fax: 201-569-9131
Mailing address:
  • Phone: 201-569-9130
  • Fax: 201-569-9131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberMA069506
License Number StateNJ

VIII. Authorized Official

Name: MS. GRACE J KIM
Title or Position: STAFF
Credential:
Phone: 201-569-9130