Provider Demographics
NPI:1003835919
Name:KIM, HOOJA C (MD)
Entity Type:Individual
Prefix:
First Name:HOOJA
Middle Name:C
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 644
Mailing Address - Street 2:
Mailing Address - City:CASTLE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:12511-0644
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 9D
Practice Address - Street 2:
Practice Address - City:CASTLE POINT
Practice Address - State:NY
Practice Address - Zip Code:12511
Practice Address - Country:US
Practice Address - Phone:845-831-2000
Practice Address - Fax:845-838-5124
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144828208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation