MEDICARE: DR. RICHARD K 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	207R00000X	Internal Medicine Physician	257436	NY
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	257436	NY
3	208000000X	Pediatrics Physician	257436	NY
4	207RS0010X	Sports Medicine (Internal Medicine) Physician	257436	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417110651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD K KIM MD

Provider Business Mailing Address
First Line	:	3 CARE LN
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-8639
Country	:	US
Telephone Number	:	518-871-9900
Fax Number	:	518-691-0236

Provider Business Practice Location Address
First Line	:	3 CARE LN
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-8639
Country	:	US
Telephone Number	:	518-871-9900
Fax Number	:	518-691-0236

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

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	02/12/2018

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