Provider Demographics
NPI:1033147368
Name:KIM, SANG HOON (MD)
Entity Type:Individual
Prefix:DR
First Name:SANG
Middle Name:HOON
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:154-39 RIVERSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BEECHHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11357
Mailing Address - Country:US
Mailing Address - Phone:646-535-0012
Mailing Address - Fax:718-670-2456
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:ENDOSCOPY SUITE
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-1159
Practice Address - Fax:718-661-7021
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2023-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY216433207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI05195Medicare UPIN
NY9255UAMedicare ID - Type Unspecified