DR. KAEJIN KIM (NPI# 1770551939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770551939 |
| Entity Type | Individual |
| Full Name | DR. KAEJIN KIM |
| Credential | M.D. |
| Practice Address |
217 Broadway Hanover PA 17331-2503 |
| Practice Telephone | 7176328944 |
| Practice Fax Number | 7176321224 |
| Mailing Telephone | 7176328944 |
| Mailing Fax Number | 7176321224 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD058104-L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0016084540002 | 05 |
| Street Address |
217 BROADWAY |
| City | HANOVER |
| State | PA |
| Zip Code | 17331-2503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295703684 | Melissa Parker Lavallee | Pediatrics | 217 Broadway, Hanover, PA 17331-2503 | 2006-03-10 |
| 1124574710 | Kathleen Elizabeth Dudley | Nurse Practitioner | 217 Broadway, Hanover, PA 17331-2503 | 2016-09-01 |
| 1497122964 | Lauren Catherine Duffy | Physician Assistant | 217 Broadway, Hanover, PA 17331 | 2015-08-31 |
| 1659461382 | Kathleen Mary Keffer | Nurse Practitioner | 217 Broadway, Hanover, PA 17331-2503 | 2006-10-13 |
| 1790874261 | Mary Rebecca Kemper | Physician Assistant | 217 Broadway, Hanover, PA 17331-2503 | 2006-10-12 |
| 1891721064 | Hanover Pediatric Associates, P.C. | Pediatrics | 217 Broadway, Hanover, PA 17331-2503 | 2006-06-23 |
| 1134197304 | Andres Valdes-dapena | Pediatrics | 217 Broadway, Hanover, PA 17331-2503 | 2006-03-14 |
| 1588632053 | Douglas Joseph Masucci | Pediatrics | 217 Broadway, Hanover, PA 17331-2503 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356977649 | Pinnacle Health Medical Services | Clinic/Center | 2201 Brunswick Drive, Suite 1100, Hanover, PA 17331 | 2020-03-18 |
| 1508421058 | National Vision Inc | Optometrist | 477 Eisenhower Drive, Hanover, PA 17331 | 2019-05-09 |
| 1225599830 | Tawney Nicole Angeloff | Registered Nurse | 1227 Baltimore Street, Hanover, PA 17331 | 2019-03-27 |
| 1851865000 | Hanh Pham-nguyen | Pharmacist | 260 Wilson Ave, Hanover, PA 17331 | 2019-01-21 |
| 1194251876 | Sam's East, Inc. | Technician/Technologist | 261 Wilson Ave, Hanover, PA 17331 | 2017-05-02 |
| 1346697794 | Pinnacle Treatment Centers Pa-vii, LLC | Clinic/Center | 120 Penn Street, Hanover, PA 17331 | 2016-05-16 |
| 1073914073 | Luana Robinson | Counselor | 36 Wappler Drive, Hanover, PA 17331 | 2014-09-09 |
| 1225467350 | Jennifer Marie Sherde | Specialist/Technologist | 250 Fame Avenue, Suite 100, Medical Fitness Center-hanover Hospital, Hanover, PA 17331 | 2013-11-08 |
| 1194078089 | Robyn Michelle Hess | Physician Assistant | 100 Eisenhower Dr, Hanover, PA 17331 | 2012-10-17 |
| 1134408453 | Heather L Hillson | Pharmacist | 31 Wilson Ave., T2567, Hanover, PA 17331 | 2011-08-04 |
| Find all providers in zip 17331 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790839868 | Vincent P Sullivan | Pediatrics | 39 Cobblestone Ln, Hanover, MA 02339-1940 | 2007-01-23 |
| 1851483986 | Ann C Bracken | Pediatrics | 7 Rope Ferry Rd, Dartmouth College Health Service, Hanover, NH 03755-1404 | 2006-09-28 |
| 1992739650 | Kelli A Kennedy | Pediatrics | 51 Mill St, Bld E, Suite 17, Hcs-hanover Pediatrics, Hanover, MA 02339 | 2006-07-10 |
| 1295703684 | Melissa Parker Lavallee | Pediatrics | 217 Broadway, Hanover, PA 17331-2503 | 2006-03-10 |
| 1679051445 | Pinnacle Health Medical Services | Pediatrics | 400 York St, Hanover, PA 17331-3357 | 2018-08-02 |
| 1235494568 | Jose Ernesto Lopez Tablas | Pediatrics | 300 Highland Ave, Hanover, PA 17331-2297 | 2012-07-12 |
| 1457654543 | Montshire Pediatrics PC | Pediatrics | 45 Lyme Rd, Hanover, NH 03755-1219 | 2010-12-10 |
| 1811214703 | Charina Cecille Reyes | Pediatrics | 7556 Teague Rd, Suite 420, Hanover, MD 21076-1213 | 2010-05-01 |
| 1467688507 | Virginia Marilyn Moore | Pediatrics | 7550 Teague Rd, 500, Hanover, MD 21076-1339 | 2009-06-03 |
| 1477704302 | Ahsan G. Mohar | Pediatrics | 300 Highland Ave, Hanover, PA 17331-2297 | 2008-10-09 |
| Find all providers in HANOVER | ||||
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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.