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General NPI Number Information
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NPI Number | 1881698322
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Entity Type | Individual
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Provider Name | DONALD D KIM O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 132-15 41ST AVE SUITE CC
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City | FLUSHING
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State | NY
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Zip | 11355-3962
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Country | US
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Telephone | 718-358-2010
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Fax |
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Provider Business Mailing Address
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Address Line | 247 CLOSTER DOCK ROAD
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City | CLOSTER
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State | NJ
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Zip | 07624-2619
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Country | US
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Telephone | 201-564-7700
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Fax | 201-564-7701
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00603100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T005484-1
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License Number State | NY
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