Individual
SANG W KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4939 BRITTONFIELD PKWY, BUILDING B, SUITE 210, EAST SYRACUSE, NY 13057-9208
(315) 471-8404
(315) 471-6803
Mailing address
4939 BRITTONFIELD PKWY, BUILDING B, SUITE 210, EAST SYRACUSE, NY 13057-9208
(315) 471-8404
(315) 471-6803
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
273922
NY
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
273922
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03855896
—
NY
Enumeration date
04/15/2008
Last updated
08/26/2014
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