Provider Demographics
NPI:1336682202
Name:RICHARD KIM M D LLC
Entity Type:Organization
Organization Name:RICHARD KIM M D LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-880-7766
Mailing Address - Street 1:113 W ESSEX ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1023
Mailing Address - Country:US
Mailing Address - Phone:201-880-7766
Mailing Address - Fax:201-880-7763
Practice Address - Street 1:113 W ESSEX ST
Practice Address - Street 2:SUITE 203
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1023
Practice Address - Country:US
Practice Address - Phone:201-880-7766
Practice Address - Fax:201-880-7763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty