Individual
DR. KIM-KING CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
718 TEANECK ROAD, TEANECK, NJ 07666
(201) 833-3000
Mailing address
66 W GILBERT ST, RED BANK, NJ 07701-4918
(732) 212-0051
(732) 212-0713
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA03194200
NJ
207R00000X
Internal Medicine Physician
25MA03194200
NJ
208D00000X
General Practice Physician
25MA03194200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5425301
—
NJ
01
—
P00674579
RAIL ROAD MEDICARE
NJ
01
—
P00766578
RR MEDICARE
PA
Enumeration date
08/15/2005
Last updated
06/17/2010
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