Kim, Jin Soo

Kim, Jin Soo is an individual health care provider with primary practice located at 320 Prather Avenue , Jamestown NY 14701-6820. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Kim, Jin Soo can be contacted via phone (716) 664-5712.

Contact Information

Primary practice address
320 Prather Avenue Jamestown NY 14701-6820
Phone: (716) 664-5712
Fax: (716) 664-4111
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 113507 New York

Profile Details

NPI number 1831105048
LBN Legal business name Kim, Jin Soo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Aug 20th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831105048 NPPES
New York MEDICAID 00639336
New York Other 000505500001

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