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Individual

ANDERSON KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
30 MALL DR W STE 100, JERSEY CITY, NJ 07310-1647
(201) 798-0303
Mailing address
16 CORDELIA CT, BUENA PARK, CA 90621-8436
(562) 754-1721

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
008417
NY
152W00000X
Optometrist
TUV008417-1
NY

Other

Enumeration date
06/18/2016
Last updated
07/10/2019
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