Kim, Seong Ja

Kim, Seong Ja is an individual health care provider with primary practice located at 438 56Th Street , Brooklyn NY 11220-3409. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Kim, Seong Ja can be contacted via phone (718) 439-4979.

Contact Information

Primary practice address
438 56Th Street Brooklyn NY 11220-3409
Phone: (718) 439-4979
Fax: (718) 439-4912
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 189738 New York
Allopathic & Osteopathic Physicians / General Practice 208D00000X A50743 California

Profile Details

NPI number 1528129350
LBN Legal business name Kim, Seong Ja
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Jul 8th, 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 1528129350 NPPES
New York MEDICAID 01466802

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