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Individual

ANTHONY C KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
60 MERRICK AVE, EAST MEADOW, NY 11554-1578
(516) 222-9300
Mailing address
21 EAGLE LN, ROSLYN, NY 11576-2501
(516) 458-7127

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
208533-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02091349
NY
Enumeration date
07/25/2006
Last updated
09/03/2014
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