MEDICARE: ISAAC KIM MD

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	2084P0800X	Psychiatry Physician	332166	NY
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1245804111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISAAC KIM MD

Provider Business Mailing Address
First Line	:	31 WOODRUFF AVE APT 3J
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-1385
Country	:	US
Telephone Number	:	917-740-5469
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BROOKDALE PLZ
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-3198
Country	:	US
Telephone Number	:	718-240-5000
Fax Number	:	718-240-6757

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

Provider Enumeration Date	:	05/16/2021
Last Update Date	:	12/03/2025

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Directions to “ ISAAC KIM MD” Practice Location

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