Jennifer Kim (NPI# 1326033366, PAC ID# 0648225896) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1326033366 |
| PAC ID by PECOS | 0648225896 |
| Professional Enrollment ID | I20100810000785 |
| Full Name | Jennifer Kim |
| Organization Legal Name | GLENDORA RADIOLOGICAL ASSOC INC |
| Address |
35 Deacons Way New Canaan CT 06840-4221 |
| Phone Number | 6263395464 |
| Gender | F |
| Credential | MD |
| Medical School | STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER |
| Graduation Year | 1996 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 2163514589 |
| Number of Group Practice Members | 38 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 070022 | YALE-NEW HAVEN HOSPITAL |
| 230236 | METRO HEALTH HOSPITAL |
| 040055 | SPARKS REGIONAL MEDICAL CENTER |
| 231316 | HILLS & DALES GENERAL HOSPITAL |
| 050382 | CITRUS VALLEY MEDICAL CENTER-IC CAMPUS |
| Address | Phone | Organization |
|---|---|---|
| 221 N Parker Hill Rd, Killingworth, CT 06419-1124 | 9525951100 | VIRTUAL RADIOLOGIC PROFESSIONALS LLC |
| 35 Deacons Way, New Canaan, CT 06840-4221 | 6263395464 | GLENDORA RADIOLOGICAL ASSOC INC |
| 35 Deacons Way, New Canaan, CT 06840-4221 | 9525951100 | VIRTUAL RADIOLOGIC PROFESSIONALS LLC |
| 20 York St, New Haven, CT 06510-3220 | 2037854638 | YALE UNIVERSITY |
| Organization Legal Name | GLENDORA RADIOLOGICAL ASSOC INC |
| Physicians | 27 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Douglas James Alden | Diagnostic Radiology | Glendora Radiological Assoc Inc | 373 Big Horn Ridge Dr Ne, Albuquerque, NM 87122-1424 |
| Duane Charles Wilson | Diagnostic Radiology | Glendora Radiological Assoc Inc | 57638 Red Alder Lane, Sunriver, OR 97707 |
| Michael J Grant | Diagnostic Radiology | Glendora Radiological Assoc Inc | 7703 N Warren Ln, Spokane, WA 99208-4978 |
| Eugene T Kim | Diagnostic Radiology | Glendora Radiological Assoc Inc | 20391 W Springfield St, Buckeye, AZ 85396-3544 |
| Catherine C Roberts | Diagnostic Radiology | Glendora Radiological Assoc Inc | 16236 N 110th St, Scottsdale, AZ 85255-2433 |
| Wendy E Zimmer | Diagnostic Radiology | Glendora Radiological Assoc Inc | 32 Saint Catherines Ct, Buffalo, NY 14222-1614 |
| Bruce J Thaler | Diagnostic Radiology | Glendora Radiological Assoc Inc | 110 S Front St, Philadelphia, PA 19106-3000 |
| Scott C Chang | Diagnostic Radiology | Glendora Radiological Assoc Inc | 8755 Killians Greens Dr, Las Vegas, NV 89131-6706 |
| Albert C Ybasco | Diagnostic Radiology | Glendora Radiological Assoc Inc | 46 Carillon Cir, Livingston, NJ 07039-2600 |
| William F Pfisterer | Interventional Radiology | Glendora Radiological Assoc Inc | 210 W San Bernardino Rd, Covina, CA 91723-1515 |
| Street Address |
35 DEACONS WAY |
| City | NEW CANAAN |
| State | CT |
| Zip | 06840-4221 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anri A Kissilenko | Psychiatry | 208 Valley Rd, New Canaan, CT 06840-3812 | |
| Donna Lcsw Dyer | Clinical Social Worker | 72 Park St, Suite 103, New Canaan, CT 06840-4532 | |
| Michele Gargan | Psychologist, Clinical | 51 Locust Ave, Suite 304, New Canaan, CT 06840-4739 | |
| Edward H Denkin | Podiatry | 51 Locust Ave, 302a, New Canaan, CT 06840-4739 | |
| Sean Awuku | Physical Therapy | Theresa Hasselrot Physical Therapy LLC | 30 Vitti St, New Canaan, CT 06840-4823 |
| Theresa P Hasselrot | Physical Therapy | Theresa Hasselrot Physical Therapy LLC | 30 Vitti St, New Canaan, CT 06840-4823 |
| David J Potucek | Physical Therapy | Theresa Hasselrot Physical Therapy LLC | 30 Vitti St, New Canaan, CT 06840-4823 |
| Sara L S Coca | Obstetrics/gynecology | Stamford Health Medical Group Inc | 161 Cherry St, New Canaan, CT 06840-4827 |
| Stephen S Gallousis | Obstetrics/gynecology | Stamford Health Medical Group Inc | 161 Cherry St, New Canaan, CT 06840-4827 |
| Adam Brodsky | Orthopedic Surgery | Orthopaedic Surgery and Sports Medicine Center Inc | 166 Cherry St, Suite B, New Canaan, CT 06840-4828 |
| Find all physicians in zip 06840 | |||
| City | NEW CANAAN |
| Zip Code | 06840 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | NEW CANAAN + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Jennifer Kim.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.