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General NPI Number Information
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NPI Number | 1285052787
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Entity Type | Individual
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Provider Name | SAMUEL KIM MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 999 FRANKLIN AVE
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City | GARDEN CITY
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State | NY
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Zip | 11530-2913
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Country | US
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Telephone | 516-535-6749
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Fax | 516-535-6761
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Provider Business Mailing Address
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Address Line | 999 FRANKLIN AVE
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City | GARDEN CITY
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State | NY
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Zip | 11530-2913
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Country | US
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Telephone | 516-535-6749
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Fax | 516-535-6761
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 328496
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 328496
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | 328496
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 328496
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License Number State | NY
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