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General NPI Number Information
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NPI Number | 1407833932
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Entity Type | Individual
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Provider Name | RICHARD KIM MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 113 W ESSEX ST STE 203
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City | MAYWOOD
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State | NJ
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Zip | 07607-1023
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Country | US
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Telephone | 201-880-7766
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Fax | 201-880-7763
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Provider Business Mailing Address
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Address Line | PO BOX 626
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City | GREAT RIVER
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State | NY
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Zip | 11739-0626
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Country | US
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Telephone | 631-892-2745
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Fax | 631-201-3179
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 25MA08272800
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License Number State | NJ
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Taxonomy #2
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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 | 25MA08272800
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License Number State | NJ
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