Individual
HAROLD J KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
62 S FULLERTON AVE, MONTCLAIR, NJ 07042-2676
(973) 746-8585
(973) 746-0088
Mailing address
62 S FULLERTON AVE, MONTCLAIR, NJ 07042-2676
(973) 746-8585
(973) 746-0088
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA07472300
NJ
207RC0000X
Cardiovascular Disease Physician
Primary
25MA07472300
NJ
207UN0901X
Nuclear Cardiology Physician
25MA07472300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118055B82
MEDICARE ID-TYPE UNSPECIFIED
NJ
01
—
643P022431
MEDICARE ID TYPE UNSPECIFIED
NY
01
—
HK0643P020
MEDICARE ID TYPE UNSPECIFIED
NY
01
—
W22431
MEDICARE ID TYPE UNSPECIFIED
NY
Enumeration date
03/27/2006
Last updated
01/25/2011
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