Dr Kaejin Kim, MD | |
217 Broadway, Hanover, PA 17331-2503 | |
(717) 632-8944 | |
(717) 632-1224 |
Full Name | Dr Kaejin Kim |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 217 Broadway, Hanover, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770551939 | NPI | - | NPPES |
0016084540002 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD058104-L (Pennsylvania) | Primary |
Entity Name | Hanover Pediatric Associates, P.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891721064 PECOS PAC ID: 1456537687 Enrollment ID: O20110523000748 |
Mailing Address | Practice Location Address |
---|---|
Dr Kaejin Kim, MD 217 Broadway, Hanover, PA 17331-2503 Ph: (717) 632-8944 | Dr Kaejin Kim, MD 217 Broadway, Hanover, PA 17331-2503 Ph: (717) 632-8944 |
Dr. Andres Valdes-dapena, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 217 Broadway, Hanover, PA 17331 Phone: 717-632-8944 Fax: 717-632-1224 | |
Jose Ernesto Lopez Tablas, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Highland Ave, Hanover, PA 17331 Phone: 717-316-3711 Fax: 717-316-3049 | |
Dr. Melissa Parker Lavallee, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 217 Broadway, Hanover, PA 17331 Phone: 717-632-8944 Fax: 717-632-1224 | |
Dr. Ahsan G. Mohar, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Highland Ave, Hanover, PA 17331 Phone: 717-316-3711 Fax: 717-316-3049 | |
Dr. Douglas Joseph Masucci, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 217 Broadway, Hanover, PA 17331 Phone: 717-632-8944 Fax: 717-632-1224 | |
Beth Smith, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Highland Ave, Hanover, PA 17331 Phone: 717-637-3711 Fax: 717-646-6914 |