DR. DONGSOO KIM (NPI# 1164609863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164609863 |
| Entity Type | Individual |
| Full Name | DR. DONGSOO KIM |
| Credential | PH.D. |
| Practice Address |
163 Engle St Ste 1a Englewood NJ 07631-2530 |
| Mailing Address |
163 Engle St 1a Englewood NJ 07631 |
| Practice Telephone | 2018941115 |
| Practice Fax Number | 2013911799 |
| Mailing Telephone | 2018941115 |
| Mailing Fax Number | 2013911799 |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2008-01-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 35SI00419400 | NJ | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770739005 | Dongsoo Kim | Pediatrics | 3101 Charann Dr, Howell, MI 48843-8612 | 2008-08-18 |
| 1881622504 | Dongsoo Kim | Internal Medicine | 102 Valentine St, Mount Vernon, NY 10550-2504 | 2006-06-29 |
| 1821016957 | Dongsoo David Kim | Dentist | 1501 Kings Hwy, Department of Oral Surgery, Shreveport, LA 71103-4228 | 2006-07-17 |
| Street Address |
163 ENGLE ST STE 1A |
| City | ENGLEWOOD |
| State | NJ |
| Zip Code | 07631-2530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326067406 | Cristian D Ciora | Psychiatry & Neurology | 163 Engle St Ste 1a, Englewood, NJ 07631-2530 | 2006-07-19 |
| 1902029770 | Anna Elberger | Social Worker | 163 Engle St Ste 1a, Englewood, NJ 07631-2530 | 2007-04-10 |
| 1689770307 | David S. Macisaac | Psychologist | 163 Engle St Ste 1a, Englewood, NJ 07631-2530 | 2006-09-16 |
| 1477560985 | Paul E Schneck | Psychiatry & Neurology | 163 Engle St Ste 1a, Englewood, NJ 07631-2530 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868922 | Sharmela Brijmohan | Student in an Organized Health Care Education/Training Program | 350 Engle Street Englewood Nj Department of Medicine, Englewood, NJ 07631 | 2020-07-21 |
| 1902422553 | Ross Tyrone Jensen Lavine | Student in an Organized Health Care Education/Training Program | 350 Engle Street, Department of Medicine, Englewood, NJ 07631 | 2020-06-19 |
| 1881235497 | Cbt and Psychodynamic Therapy Associates LLC | Social Worker | 245 Walnut Street, Englewood, NJ 07631 | 2019-10-04 |
| 1346895950 | Eb Care At Englewood, LLC | Assisted Living Facility | 412 South Van Brunt Street, Englewood, NJ 07631 | 2019-08-09 |
| 1730695727 | Maytal Elart | Spec/Tech, Cardiovascular | 151 E Palisades Ave, 16e, Englewood, NJ 07631 | 2017-12-28 |
| 1396259255 | Elizabeth Thottumalil Thomas | Counselor | 93 West Palisade Ave, Englewood, NJ 07631 | 2017-11-29 |
| 1992214381 | Englewood Orthopedics Group PC | Orthopaedic Surgery | 55 Smith St Unit 5653, Englewood, NJ 07631 | 2017-09-28 |
| 1639691579 | Jee Hoon Jang | Student in an Organized Health Care Education/Training Program | 350 Engle St., Englewood, NJ 07631 | 2017-07-12 |
| 1427570332 | Dan Ran Castillo | Student in an Organized Health Care Education/Training Program | 350 Engel Street, Engelwood, NJ 07631 | 2017-07-12 |
| 1275061392 | Thomas J Drexler | Counselor | 93 W. Palisades Ave, Englewood, NJ 07631 | 2017-06-02 |
| Find all providers in zip 07631 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184102790 | Emily Claire Maxwell | Clinical Neuropsychologist | 10111 Inverness Main St Unit 417, Englewood, CO 80112-5727 | 2018-08-06 |
| 1649674524 | Jennifer E Medina Phd PC | Clinical Neuropsychologist | 3333 S Bannock St Ste 1010, Englewood, CO 80110-2432 | 2014-10-21 |
| 1316238611 | Kevin J. Reilly, Psy.d.,p.c. | Clinical Neuropsychologist | 601 E Hampden Ave Ste 420, Englewood, CO 80113-2770 | 2011-04-21 |
| 1144389172 | Colorado Center for Neurological Rehabilitation Inc | Clinical Neuropsychologist | 7400 E Arapahoe Road, Suite 212, Englewood, CO 80112 | 2006-12-06 |
| 1972525848 | Kenneth Craig Kutner | Clinical Neuropsychologist | 440 Curry Ave Ste B, Englewood, NJ 07631-1794 | 2006-07-23 |
| 1528087244 | Kevin J Reilly | Clinical Neuropsychologist | 601 East Hampden Avenue, Suite 420, Englewood, CO 80113 | 2006-07-19 |
| 1730118571 | Hasson Psychological Group LLC | Clinical Neuropsychologist | 185 Engle St Fl 2, Englewood, NJ 07631-2409 | 2006-07-02 |
| 1952365462 | Jay Schneiders | Clinical Neuropsychologist | 3601 S Clarkson St Ste 530, Englewood, CO 80113-3949 | 2006-04-12 |
| 1922648328 | Heather Snead | Clinical Neuropsychologist | 499 E Hampden Ave Ste 360, Englewood, CO 80113-3877 | 2020-01-14 |
| 1730637489 | James C. Berry, Phd, LLC | Clinical Neuropsychologist | 3425 S Clarkson St, Englewood, CO 80113-2811 | 2016-09-12 |
| Find all providers in ENGLEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.