Individual
MYUNGDUK ROGER KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BROOKDALE PLZ, ROOM 244, BROOKLYN, NY 11212-3139
(718) 240-5668
(718) 240-6513
Mailing address
1 BROOKDALE PLAZA, STRAUSBERG SUITE 244, BROOKDALE UNIVERSITY HOSPITAL AND MEDICAL CENTER, BROOKLYN, NY 11212
(718) 240-5628
(718) 240-6513
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
178690
NY
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
178690
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01404448
—
NY
Enumeration date
06/08/2006
Last updated
12/20/2013
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