Individual
DR. CHANGRAE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6508 GRAND AVE, MASPETH, NY 11378-2423
(917) 359-3937
Mailing address
2 BAY CLUB DR APT 5X, BAYSIDE, NY 11360-2921
(917) 359-3937
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
006653
NY
Other
Enumeration date
07/31/2014
Last updated
08/31/2014
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