Individual
DR. CHULSOON KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3725 75TH ST, JACKSON HEIGHTS, NY 11372-6422
(718) 507-6262
Mailing address
3725 75TH ST, JACKSON HEIGHTS, NY 11372-6422
(718) 507-6262
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
117576-1
NY
208D00000X
General Practice Physician
Primary
117576-1
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00218268
—
NY
01
—
0073578
GHI
NM
01
—
117576-A17
HEALTHFIRST
NY
01
—
169119
ELDERPLAN
NY
01
—
17-00464
UNITED HEALTHCARE
NY
01
—
673881 CK
BLUE CROSS & BLUE SHIELD
NY
01
—
P00104843
RAILROAD MEDICARE
—
01
—
P3602724
OXFORD
NY
Enumeration date
02/02/2007
Last updated
09/11/2025
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