Individual
DR. BACK KYUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13668 ROOSEVELT AVE, FLUSHING, NY 11354-5510
(718) 997-9000
(718) 997-8880
Mailing address
13620 38TH AVE, SUITE 8J, FLUSHING, NY 11354-4277
(718) 997-9000
(718) 997-8880
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
202578
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01753162
—
NY
Enumeration date
12/05/2006
Last updated
01/02/2018
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