Healthcare Provider Details

I. General information

NPI: 1679482251
Provider Name (Legal Business Name): CHRISTOPHER J KIM DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 ROBIN RD STE 118
PARAMUS NJ
07652-1424
US

IV. Provider business mailing address

588 ABBOTT AVE
RIDGEFIELD NJ
07657-2443
US

V. Phone/Fax

Practice location:
  • Phone: 844-366-8800
  • Fax:
Mailing address:
  • Phone: 201-696-8392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02436000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: