Provider Demographics
NPI:1710646526
Name:ANN KIM MD NY PC
Entity Type:Organization
Organization Name:ANN KIM MD NY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-961-2808
Mailing Address - Street 1:44 SYLVAN AVE STE 2D
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2417
Mailing Address - Country:US
Mailing Address - Phone:201-961-2808
Mailing Address - Fax:201-585-0957
Practice Address - Street 1:401 COLUMBUS AVE STE 2
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1375
Practice Address - Country:US
Practice Address - Phone:201-585-0957
Practice Address - Fax:201-585-0957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty