Individual
ETHAN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
80 SEYMOUR ST, HARTFORD, CT 06106-3300
(860) 545-5000
Mailing address
99 EAST RIVER DRIVE, 5TH FLOOR, EAST HARTFORD, CT 06108-7301
(860) 282-0833
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
66520
CT
207L00000X
Anesthesiology Physician
A155758
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
04/16/2014
Last updated
04/16/2021
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