Individual
DR. TAIK H KIM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 MARYS AVE, KINGSTON, NY 12401-5852
(845) 339-7700
Mailing address
1020A E BOAL AVE, BOALSBURG, PA 16827-1509
(814) 237-8627
(814) 238-0083
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
154290
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000470811002
BCBS NE NY
NY
01
—
000478081002
BCBS NE NY
NY
01
—
0034642
GHI
NY
05
—
00824153
—
NY
01
—
0885566
AETNA USHC
NY
01
—
10038783
CDPHP
NY
01
—
13261
GHI
NY
01
—
15D911
EMPIRE BCBS
NY
01
—
2329614
AETNA USHC HMO
NY
01
—
397001
MVP
NY
01
—
397114
MVP
NY
01
—
4336394
AETNA USHC PPO
NY
01
—
930711
EMPIRE BCBS
NY
01
—
9567121
GHI PPO
NY
01
—
P2548529
OXFORD LIBERTY
NY
Enumeration date
01/14/2006
Last updated
07/08/2007
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