Kim, Sang W

Kim, Sang W is an individual health care provider with primary practice located at 4939 Brittonfield Pkwy Building B, Suite 210, East Syracuse NY 13057-9208. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck, Allopathic & Osteopathic Physicians / Facial Plastic Surgery. Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck is his primary health care specialty. Kim, Sang W can be contacted via phone (315) 471-8404.

Contact Information

Primary practice address
4939 Brittonfield Pkwy Building B, Suite 210 East Syracuse NY 13057-9208
Phone: (315) 471-8404
Fax: (315) 471-6803
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck 207YX0007X 273922 New York
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X 273922 New York

Profile Details

NPI number 1548434236
LBN Legal business name Kim, Sang W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2008
Last updated Aug 26th, 2014 - about 12 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 1548434236 NPPES
New York MEDICAID 03855896

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