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General NPI Number Information
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NPI Number | 1366255036
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Entity Type | Individual
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Provider Name | DANIEL S KIM
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Gender | Male
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 186 PATERSON AVE
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City | EAST RUTHERFORD
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State | NJ
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Zip | 07073-1837
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Country | US
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Telephone | 551-316-9917
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Fax |
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Provider Business Mailing Address
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Address Line | 221 E COLUMBIA AVE UNIT B
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City | PALISADES PARK
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State | NJ
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Zip | 07650-1901
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Country | US
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Telephone | 201-658-0104
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00174200
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License Number State | NJ
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