Individual
MINBAE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
703 MAIN ST, DEPT. OF PATHOLOGY, PATERSON, NJ 07503-2621
(973) 754-2000
(973) 754-3649
Mailing address
PO BOX 144333, ORLANDO, FL 32814-4333
(407) 422-9831
(407) 648-2065
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25MA04741200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220031464
RAILROAD MEDICARE
—
05
—
3839907
—
NJ
Enumeration date
11/22/2005
Last updated
08/03/2007
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