Individual
SOOJI KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
233 BROADWAY RM 1775, NEW YORK, NY 10279-1810
(212) 921-7900
Mailing address
23 SARATOGA ST, TAPPAN, NY 10983-2620
(845) 642-8851
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
006777
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006777
LICENSE
NY
05
—
04524594
—
NY
Enumeration date
11/10/2014
Last updated
12/14/2020
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