Provider Demographics
NPI:1558943068
Name:KIM, BRIAN H (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:H
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2360 LAKEWOOD RD STE 3-117
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1929
Mailing Address - Country:US
Mailing Address - Phone:732-503-8218
Mailing Address - Fax:732-913-5163
Practice Address - Street 1:14 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6402
Practice Address - Country:US
Practice Address - Phone:732-503-8218
Practice Address - Fax:732-913-5163
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA12667800208100000X
IL125079199208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation