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Individual

DR. MOON Y. KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
36 HILLCREST DR, UPPER SADDLE RIVER, NJ 07458-2004
(201) 825-3454
Mailing address
36 HILLCREST DR, UPPER SADDLE RIVER, NJ 07458-2004
(201) 825-3454

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
118587
NY
207L00000X
Anesthesiology Physician
Primary
25MA02776100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00347860
NY
05
1092006
NJ
Enumeration date
08/18/2005
Last updated
08/05/2008
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