# KS PODIATRY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710220561
- **Authorized official:** KWANGSU KIM DPM (PRESIDENT)
- **Authorized official phone:** (718) 229-9200

## Contact information

- **Practice address:** 21909 NORTHERN BLVD, BAYSIDE, NY 11361-3525
- **Practice address phone:** (718) 229-9200
- **Practice address fax:** (866) 668-7533
- **Mailing address:** 995 OLD COUNTRY RD, PLAINVIEW, NY 11803-4906
- **Mailing address phone:** (718) 229-9200
- **Mailing address fax:** (866) 668-7533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | N006264 | NY | Yes |

## Other

- **Enumeration date:** 03/30/2013
- **Last updated:** 10/22/2025