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General NPI Number Information
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NPI Number | 1730174715
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Entity Type | Individual
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Provider Name | KATHLYN KIM
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Gender | Female
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 581 N FRANKLIN TPKE
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City | RAMSEY
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State | NJ
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Zip | 07446-1139
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Country | US
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Telephone | 201-236-2100
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Fax | 201-236-5081
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Provider Business Mailing Address
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Address Line | 581 N FRANKLIN TPKE
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City | RAMSEY
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State | NJ
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Zip | 07446-1139
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Country | US
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Telephone | 201-236-2100
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Fax | 201-236-5081
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA06066900
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License Number State | NY
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