Provider Demographics
NPI:1922096536
Name:KIM, JIN BAI (MD)
Entity Type:Individual
Prefix:
First Name:JIN
Middle Name:BAI
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 MITCHELL AVE
Mailing Address - Street 2:STE 108
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-1674
Mailing Address - Country:US
Mailing Address - Phone:607-722-2275
Mailing Address - Fax:607-773-8428
Practice Address - Street 1:33 MITCHELL AVE
Practice Address - Street 2:STE 108
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-1674
Practice Address - Country:US
Practice Address - Phone:607-722-2275
Practice Address - Fax:607-773-8428
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY179395208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation