Provider Demographics
NPI:1528029808
Name:LO, KIM SING (DO)
Entity Type:Individual
Prefix:DR
First Name:KIM SING
Middle Name:
Last Name:LO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:110 LAFAYETTE ST
Mailing Address - Street 2:201
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4116
Mailing Address - Country:US
Mailing Address - Phone:212-966-6655
Mailing Address - Fax:212-966-6226
Practice Address - Street 1:110 LAFAYETTE ST
Practice Address - Street 2:201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4116
Practice Address - Country:US
Practice Address - Phone:212-966-6655
Practice Address - Fax:212-966-6226
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY183269204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02194961Medicaid
NYE70364Medicare UPIN
NY02194961Medicaid