Provider Demographics
NPI:1225048697
Name:CHRISTOPHER KIM REHAB.,INC.
Entity Type:Organization
Organization Name:CHRISTOPHER KIM REHAB.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-669-0077
Mailing Address - Street 1:80 REVERE BLVD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1907
Mailing Address - Country:US
Mailing Address - Phone:732-669-0077
Mailing Address - Fax:732-669-0076
Practice Address - Street 1:34 PROGRESS ST # 36
Practice Address - Street 2:SUITE A 7
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1103
Practice Address - Country:US
Practice Address - Phone:732-669-0077
Practice Address - Fax:732-669-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07159600208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8968209Medicaid
NJ8968209Medicaid
NJH39504Medicare UPIN