MEDICARE: GLORIA KIM OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	27OA00635500	NJ
2	152W00000X	Optometrist	270OA00635500	NJ

General Provider Information

NPI Number	:	1104101492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA KIM OD

Provider Business Mailing Address
First Line	:	543 RIVER RD
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1146
Country	:	US
Telephone Number	:	201-654-9127
Fax Number	:

Provider Business Practice Location Address
First Line	:	543 RIVER RD
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1146
Country	:	US
Telephone Number	:	201-654-9127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2011
Last Update Date	:	02/18/2026

Similar Medicare Providers

1497772420 — DR. TARYN V TAPIA O.D.
Practice Location Address:

543 RIVER RD
EDGEWATER, NJ
07020-1146

Practice Phone: 201-941-7331
Practice Fax:

1659393262 — NEW JERSEY CVS PHARMACY LLC
Practice Location Address:

543 RIVER RD
EDGEWATER, NJ
07020-1146

Practice Phone: 201-402-0253
Practice Fax: 201-402-0253

1407906142 — LUXOTTICA OF AMERICA INC
Practice Location Address:

543 RIVER RD
EDGEWATER, NJ
07020-1146

Practice Phone: 201-402-0255
Practice Fax:

1336468594 — LINDA VELAZQUEZ PHARMD.
Practice Location Address:

543 RIVER RD
EDGEWATER, NJ
07020-1146

Practice Phone: 201-402-0253
Practice Fax: 201-402-0253

1295055234 — PAOLA ANDREA GUTIERREZ
Practice Location Address:

521 RIVER RD FL 2
EDGEWATER, NJ
07020-1146

Practice Phone: 201-943-3030
Practice Fax: 201-943-3039

1669760187 — MR. ANDREW S KIM
Practice Location Address:

543 RIVER RD , T-1263
EDGEWATER, NJ
07020-1146

Practice Phone: 201-402-0253
Practice Fax:

Directions to “ GLORIA KIM OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.