Individual
DR. MARTIN SUNG KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
121 BROAD AVE, PALISADES PARK, NJ 07650-1441
(201) 346-1500
(201) 346-1549
Mailing address
234 KNOX AVE, UNIT B, CLIFFSIDE PARK, NJ 07010-2510
(201) 421-9319
(201) 945-3470
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
006044
NY
152W00000X
Optometrist
27OA00604800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0129011
—
NJ
05
—
02837805
—
NY
Enumeration date
07/06/2006
Last updated
03/31/2017
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