Provider Demographics
NPI:1518082213
Name:STEVE Y. KIM M.D.
Entity Type:Organization
Organization Name:STEVE Y. KIM M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-569-9130
Mailing Address - Street 1:385 SYLVAN AVE
Mailing Address - Street 2:SUITE #26
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2726
Mailing Address - Country:US
Mailing Address - Phone:201-569-9130
Mailing Address - Fax:201-569-9131
Practice Address - Street 1:385 SYLVAN AVE
Practice Address - Street 2:SUITE #26
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2726
Practice Address - Country:US
Practice Address - Phone:201-569-9130
Practice Address - Fax:201-569-9131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA069506207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8015805Medicaid
NJ01979804Medicaid
NJG56192Medicare UPIN
NJ029463Medicare ID - Type Unspecified
NJ01979804Medicaid