Individual
JEONGWON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1608 LEMOINE AVE STE 206, FORT LEE, NJ 07024-5622
(917) 301-5821
Mailing address
1608 LEMOINE AVE STE 206, FORT LEE, NJ 07024-5622
(917) 301-5821
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
42398
CT
207RI0200X
Infectious Disease Physician
Primary
230641
NY
Other
Enumeration date
07/28/2005
Last updated
03/13/2023
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