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General NPI Number Information
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NPI Number | 1710081054
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Entity Type | Organization
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Legal Business Name | KYUNG H KIM MD PC
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 262 E PROSPECT AVE
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City | MT VERNON
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State | NY
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Zip | 10550-1605
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Country | US
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Telephone | 914-668-2600
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Fax | 914-668-6102
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Provider Business Mailing Address
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Address Line | 262 E PROSPECT AVE
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City | MT VERNON
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State | NY
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Zip | 10550-1605
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Country | US
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Telephone | 914-668-2600
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Fax | 914-668-6102
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Authorized Official
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Title or Position | MD
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Name | KYUNG H KIM
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Credential | MD PC
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Telephone | 914-668-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 150848
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License Number State | NY
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