Healthcare Provider Details

I. General information

NPI: 1912823287
Provider Name (Legal Business Name): KEVIN HS KIM PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 SOMERSET ST
SOMERVILLE NJ
08876-2814
US

IV. Provider business mailing address

129 SOMERSET ST
SOMERVILLE NJ
08876-2814
US

V. Phone/Fax

Practice location:
  • Phone: 908-725-8259
  • Fax: 908-429-9248
Mailing address:
  • Phone: 908-725-8259
  • Fax: 908-429-9248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04497900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: