Provider Demographics
NPI:1629047329
Name:DANIEL KIM, M.D., TOTAL EYE CARE, P.C.
Entity Type:Organization
Organization Name:DANIEL KIM, M.D., TOTAL EYE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:RYU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-661-3800
Mailing Address - Street 1:13633 37TH AVE STE 4C
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4562
Mailing Address - Country:US
Mailing Address - Phone:718-661-3800
Mailing Address - Fax:718-661-3812
Practice Address - Street 1:4161 KISSENA BLVD
Practice Address - Street 2:C#24
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3105
Practice Address - Country:US
Practice Address - Phone:718-661-3800
Practice Address - Fax:718-661-3812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194095174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113385110OtherUNICARE
NY2033258OtherAETNA HMO
NY01755297Medicaid
NY1309275OtherFIRST HEALTH
NY6013281OtherGHI
NY67S631OtherEMPIRE BCBS
NY2C7998OtherHEALTHNET
NYP627446OtherOXFORD
CT113385110003OtherCIGNA
NY5143562OtherAETNA PPO
NY6013281OtherGHI
NY=========OtherMULTIPLAN
NY=========OtherPHCS
NY5143562OtherAETNA PPO
NYP627446OtherOXFORD