Physician Compare National (NPI:1265888473)

HEALTHCARE PROVIDER: KYONG KIM D.P.M

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1265888473
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648604736
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200721002000
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KIM
	Individual professional last name
Provider First Name	KYONG
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	BARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2225 LEMOINE AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	FL 1
	Group Practice or individual's line 2 address
City	FORT LEE
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	070246104
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7866172905
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y