Individual
DR. IL JIN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
90 W 225TH ST, BRONX, NY 10463-7002
(718) 664-2164
Mailing address
8638 TOWN AND COUNTRY BLVD APT B, ELLICOTT CITY, MD 21043-2906
(443) 765-7002
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008772
NY
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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