Organization
FORT LEE INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEONGWON KIM MD (OWNER)
(917) 301-5821
Entity
Organization
Contact information
Practice address
1608 LEMOINE AVE STE 206, FORT LEE, NJ 07024-5622
(917) 301-5821
Mailing address
279 TREMONT AVE, FORT LEE, NJ 07024-5232
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA09382300
NJ
Other
Enumeration date
09/14/2017
Last updated
06/20/2018
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