Individual
DR. JONGHO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 W 168TH ST # MC28, NEW YORK, NY 10032-3725
(917) 882-8208
Mailing address
306 RIVEREDGE RD, TENAFLY, NJ 07670-1938
(917) 882-8208
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
290542
NY
207U00000X
Nuclear Medicine Physician
C1-0026366
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
860279748
UNITEDHEALTHCARE
NY
Enumeration date
05/29/2008
Last updated
08/24/2023
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