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General NPI Number Information
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NPI Number | 1073854501
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Entity Type | Organization
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Legal Business Name | DR JOHN KIMS MEDICAL OFFICE PC
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 2815 JOHN F KENNEDY BLVD 2C
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City | JERSEY CITY
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State | NJ
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Zip | 07306-3900
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Country | US
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Telephone | 201-946-6923
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Fax | 201-946-6924
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Provider Business Mailing Address
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Address Line | 2815 JOHN F KENNEDY BLVD 2C
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City | JERSEY CITY
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State | NJ
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Zip | 07306-3936
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Country | US
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Telephone | 201-946-6923
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Fax | 201-946-6924
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Authorized Official
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Title or Position | M.D.
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Name | DOEYOUNG KIM
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Credential |
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Telephone | 201-946-6923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 25MA08080200
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License Number State | NJ
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