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General NPI Number Information
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NPI Number | 1073582805
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Entity Type | Organization
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Legal Business Name | DANIEL Y. KIM, M.D., P.A.
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 08/01/2012
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Provider Practice Location Address
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Address Line | 540 BERGEN BLVD
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City | PALISADES PARK
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State | NJ
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Zip | 07650-2322
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Country | US
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Telephone | 201-461-3970
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Fax | 201-242-9061
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Provider Business Mailing Address
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Address Line | 540 BERGEN BLVD
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City | PALISADES PARK
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State | NJ
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Zip | 07650-2322
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Country | US
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Telephone | 201-461-3970
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Fax | 201-242-9061
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Authorized Official
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Title or Position | BILLING
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Name | LENA KIM
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Credential |
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Telephone | 201-461-3970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MA65006
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License Number State | NJ
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