Individual
CHANG W KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 WATERS PL, BRONX, NY 10461-2723
(718) 931-0600
Mailing address
596C HERITAGE HLS, SOMERS, NY 10589-1908
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
113502
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113502
—
NY
Enumeration date
03/20/2007
Last updated
04/19/2026
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