Organization
SHK PREMIER GASTROENTEROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANG KIM MD (PRESIDENT)
(646) 354-0416
Entity
Organization
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(718) 670-1159
(718) 670-2456
Mailing address
15439 RIVERSIDE DR, BEECHHURST, NY 11357-1339
(646) 354-0416
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
216433
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02728210
—
NY
01
—
9255UA
GHI MEDICARE
NY
Enumeration date
01/02/2009
Last updated
01/08/2009
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