Individual
DR. SOO CHONG KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
360 ESSEX ST STE 401, HACKENSACK, NJ 07601
(551) 996-1140
(551) 996-0543
Mailing address
360 ESSEX ST STE 401, HACKENSACK, NJ 07601-8566
(551) 996-1140
(551) 996-0543
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
25MA09671600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0459810
—
NJ
Enumeration date
06/10/2011
Last updated
07/18/2018
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