Individual
DR. KAK RAE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
56-45 MAIN STREET, W-LL300, FLUSHING, NY 11355-5046
(718) 445-0220
(718) 939-1167
Mailing address
56-45 MAIN STREET, W-LL300, FLUSHING, NY 11355-5046
(718) 445-0220
(718) 939-1167
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
253086
NY
2086S0129X
Vascular Surgery Physician
Primary
253086
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03113173
—
NY
01
—
P00871353
RAILROAD
NY
Enumeration date
06/12/2007
Last updated
04/13/2011
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