Individual
SAMUEL W KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 COLUMBIA ST, DRA IMAGING, PC, POUGHKEEPSIE, NY 12601-3923
(845) 454-4700
Mailing address
15 BITTERSWEET LN, GLEN COVE, NY 11542-1617
(516) 263-8836
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
231881
NY
2085R0202X
Diagnostic Radiology Physician
Primary
231881
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02802124
—
NY
Enumeration date
10/10/2006
Last updated
05/01/2008
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