KYU-JIN KIM (NPI# 1215289491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215289491 |
| Entity Type | Individual |
| Full Name | KYU-JIN KIM |
| Credential | M.D. |
| Practice Address |
7575 Firebird Lane Manlius NY 13104-9334 |
| Mailing Address |
7575 Firebird Lane Manlius NY 13104 |
| Practice Telephone | 3156827185 |
| Mailing Telephone | 3156827185 |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2012-10-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 123715 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
7575 FIREBIRD LANE |
| City | MANLIUS |
| State | NY |
| Zip Code | 13104-9334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790334423 | Cindy Gleason | Technician | 8450 Number 2 Rd East, Manlius, NY 13104 | 2019-09-05 |
| 1275009995 | Tristan Karel Martin | Marriage & Family Therapist | 4500 Pewter Lane, 8&9, Manlius, NY 13104 | 2018-10-20 |
| 1184141715 | Walgreen Co | Pharmacy | 315 Fayette St Ste 3, Manlius, NY 13104 | 2017-08-24 |
| 1518233386 | Edward Theodore Schroeder | Internal Medicine | 8345 Vassar Drive, Manlius, NY 13104 | 2012-03-27 |
| 1790052017 | Megan Lynn Perioli | Counselor | 8219 Market Pl Bldg 10, Manlius, NY 13104 | 2011-12-01 |
| 1194979088 | Erin Elizabeth Kolceski | Speech-Language Pathologist | 8141 Old Sunridge Dr, Manlius, NY 13104 | 2008-11-05 |
| 1700037314 | Peter H Emery Jr. | Pharmacist | 3215 Pompey Center Road, Manlius, NY 13104 | 2008-10-02 |
| 1093987216 | Jason David Henderson | Dentist | 8179 Cazenovia Rd., Manlius, NY 13104 | 2008-03-27 |
| 1154517019 | Cynthia E Cavanaugh | Registered Nurse | 2968 Gulf Rd, Manlius, NY 13104 | 2007-09-24 |
| 1487853537 | Harold Jason Rodman | Dentist | 28 Lincklaen St, Cazenovia, NY 13104 | 2007-07-17 |
| Find all providers in zip 13104 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003420472 | Theodean Smith-lawrence | General Practice | 7 Smoke Rise Ln, Wappingers Falls, NY 12590-1220 | 2020-09-03 |
| 1891304325 | Christopher R. Page, M.d., Pllc | General Practice | 46 Route 25a Ste 6, Setauket, NY 11733-2807 | 2020-07-30 |
| 1740804442 | Aliza Hakimian | General Practice | 15 Hill Park Ave Apt 2n, Great Neck, NY 11021-3709 | 2020-05-29 |
| 1962022152 | Lynnette Lallave - Cortes | General Practice | 2 Seaman Ave Apt 1d, New York, NY 10034-2904 | 2020-04-17 |
| 1942829759 | Northeasttelemedicine | General Practice | 483 Coolidge Hill Rd, Diamond Point, NY 12824 | 2020-04-11 |
| 1578198826 | Online Care Medicine PC | General Practice | 26 Oldox Rd, Delmar, NY 12054-2943 | 2020-03-06 |
| 1821621301 | Donnet Andrea Riley | General Practice | 781 Palmer Rd Apt 3a, Bronxville, NY 10708-3309 | 2020-02-12 |
| 1104463652 | Ohad Shimshon Bentur | General Practice | 450 E 63rd St Apt 3g, New York, NY 10065-7957 | 2019-12-03 |
| 1285278291 | Echo Clinical Associates LLC | General Practice | 56 Echo Ave., Ste 1, Miller Place, NY 11764-2454 | 2019-11-01 |
| 1710528583 | Debra Heverly | General Practice | 2315 Whirlpool St # 415, Niagara Falls, NY 14305-2413 | 2019-10-03 |
| Find all providers with the same taxonomy | ||||
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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.