Individual
AGNES KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, CARDIOLOGY, FARMINGTON, CT 06030-2202
(860) 679-3343
(860) 679-4256
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
044570
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255490348
—
CT
Enumeration date
12/06/2006
Last updated
11/07/2022
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