Provider Demographics
NPI:1902224587
Name:KIM, SAMUEL M
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:M
Last Name:KIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WEILL CORNELL MEDICINE DIVISION OF CARDIOLOGY
Mailing Address - Street 2:1305 YORK AVENUE 8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5663
Mailing Address - Country:US
Mailing Address - Phone:646-962-5558
Mailing Address - Fax:646-962-0050
Practice Address - Street 1:WEILL CORNELL MEDICINE DIVISION OF CARDIOLOGY
Practice Address - Street 2:520 EAST 70TH STREET, STARR PAVILION 4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0010
Practice Address - Country:US
Practice Address - Phone:646-962-5558
Practice Address - Fax:646-962-0050
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY288447207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology