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General NPI Number Information
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NPI Number | 1528129350
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Entity Type | Individual
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Provider Name | SEONG JA KIM MD
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Gender | Female
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 438 56TH STREET
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City | BROOKLYN
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State | NY
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Zip | 11220-3409
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Country | US
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Telephone | 718-439-4979
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Fax | 718-439-4912
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Provider Business Mailing Address
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Address Line | 146 67TH STREET
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City | BROOKLYN
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State | NY
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Zip | 11220-4822
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Country | US
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Telephone | 718-439-4979
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Fax | 718-492-4965
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 189738
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A50743
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License Number State | CA
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