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NPI Code Detail

MEDICARE: JIN H KIM M.D.

MEDICARE: JIN H KIM M.D.
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
1207L00000XAnesthesiology Physician25MA02672800NJ

Other Identifiers

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

General Provider Information

NPI Number : 1417950049
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIN H KIM M.D.
Provider Business Mailing Address
First Line : PO BOX 26960
Second Line :
City : NEW YORK
State : NY
Zip : 10087-6960
Country : US
Telephone Number : 201-804-2800
Fax Number :
Provider Business Practice Location Address
First Line : 25 POCONO RD
Second Line :
City : DENVILLE
State : NJ
Zip : 07834-2954
Country : US
Telephone Number : 973-625-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 06/24/2009

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