Individual
DR. JOHN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
158 LINWOOD PLZ STE 324-325, FORT LEE, NJ 07024-3761
(201) 944-7300
(201) 944-7311
Mailing address
PO BOX 1898, FORT LEE, NJ 07024-8398
(201) 944-7300
(201) 944-7311
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA06862000
NJ
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
25MA06862000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891011854
TYPE II NPI
NJ
05
—
7954603
—
NJ
05
—
7954604
—
NJ
Enumeration date
01/04/2006
Last updated
07/21/2022
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