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General NPI Number Information
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NPI Number | 1538161377
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Entity Type | Organization
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Legal Business Name | JIN P KIM MD
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 330 WOODSTOWN RD MEDICAL ARTS BLDG 2
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City | SALEM
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State | NJ
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Zip | 08079
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Country | US
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Telephone | 856-935-2577
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Fax | 856-935-0726
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Provider Business Mailing Address
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Address Line | 330 WOODSTOWN RD MEDICAL ARTS BLDG 2
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City | SALEM
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State | NJ
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Zip | 08079
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Country | US
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Telephone | 856-935-2577
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Fax | 856-935-0726
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LINDA S BOOTH
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Credential |
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Telephone | 856-935-2577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 25MA02960300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 25MA02960300
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License Number State | NJ
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