Individual
DIANE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(267) 964-0784
Mailing address
321 SAINT ANN DR, NISKAYUNA, NY 12309-1194
(518) 527-6781
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
310460
NY
208000000X
Pediatrics Physician
Primary
MD478920
PA
Other
Enumeration date
04/07/2018
Last updated
11/28/2022
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