Provider Demographics
NPI:1477949360
Name:KIM, SARA KA RHAM (MD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:KA RHAM
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:101 NICOLLS RD
Mailing Address - Street 2:STONY BROOK MEDICINE DEPARTMENT OF OB/GYN HSC T9
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8094
Mailing Address - Country:US
Mailing Address - Phone:631-444-4686
Mailing Address - Fax:631-444-4622
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:STONY BROOK MEDICINE DEPARTMENT OF OB/GYN HSC T9
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8094
Practice Address - Country:US
Practice Address - Phone:631-444-4686
Practice Address - Fax:631-444-4622
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2022-04-09
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY299291207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program