Individual
ELLEN J KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3400 CIVIC CENTER BLVD, 1-330S PERELMAN CENTER, PHILADELPHIA, PA 19104-4206
(215) 662-2737
(215) 615-3424
Mailing address
3400 CIVIC CENTER BLVD, PCAM 1 SOUTH, PHILADELPHIA, PA 19104-4206
(215) 662-2737
(215) 615-3424
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
25MA11711000
NJ
207N00000X
Dermatology Physician
Primary
MD420475
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019182500001
—
PA
Enumeration date
07/17/2006
Last updated
11/06/2025
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