Kim, Martin Sung
Kim, Martin Sung is an sole proprietor health care provider with primary practice located at 121 Broad Ave , Palisades Park NJ 07650-1441. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kim, Martin Sung can be contacted via phone (201) 346-1500.Contact Information
Primary practice address
121 Broad Ave
Palisades Park NJ 07650-1441
Phone: (201) 346-1500
Fax: (201) 346-1549
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 006044 | New York |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 27OA00604800 | New Jersey |
Profile Details
| NPI number | 1801827795 |
|---|---|
| LBN Legal business name | Kim, Martin Sung |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 6th, 2006 |
| Last updated | Mar 31st, 2017 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801827795 | NPPES |
| New York | MEDICAID | 02837805 | |
| New York | MEDICAID | 0129011 |
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