Individual
DR. DAESONG KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
(631) 266-6022
Mailing address
12 MOUNTAIN LAUREL LN, KINGS PARK, NY 11754-1017
(631) 269-9644
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
129350
NY
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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