Provider Demographics
NPI:1639603244
Name:CHRISTIAN KIM MD, PC
Entity Type:Organization
Organization Name:CHRISTIAN KIM MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-724-3890
Mailing Address - Street 1:193 CREST DR
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-5209
Mailing Address - Country:US
Mailing Address - Phone:201-724-3890
Mailing Address - Fax:
Practice Address - Street 1:1608 LEMOINE AVE
Practice Address - Street 2:STE 203
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5636
Practice Address - Country:US
Practice Address - Phone:201-724-3890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty