Provider Demographics
NPI:1275658106
Name:KIM, MAUREEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:L
Last Name:KIM
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Gender:F
Credentials:MD
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Mailing Address - Street 1:30 PROSPECT AVE
Mailing Address - Street 2:WFAN BLDG PC218
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1915
Mailing Address - Country:US
Mailing Address - Phone:551-996-5362
Mailing Address - Fax:551-996-3232
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:WFAN BLDG PC218
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-0760
Practice Address - Country:US
Practice Address - Phone:551-996-5362
Practice Address - Fax:551-996-3232
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2022-03-22
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Provider Licenses
StateLicense IDTaxonomies
NY2390422080N0001X
NJ25MA105466002080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine