Individual
KENNETH K. KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1656 CHAMPLIN AVE, UTICA, NY 13502-4830
(315) 624-6000
Mailing address
1656 CHAMPLIN AVE, UTICA, NY 13502-4830
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
120136-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00543444
—
NY
Enumeration date
10/31/2005
Last updated
03/18/2013
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