Provider Demographics
NPI:1518272855
Name:STEVE Y KIM MD PC
Entity Type:Organization
Organization Name:STEVE Y KIM MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
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:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G56192Medicare UPIN