Kim Medical Of New York Pllc | |
255 Executive Dr Ste 210b Plainview NY 11803-1711 | |
(833) 433-2273 | |
Not Available |
Full Name | Kim Medical Of New York Pllc |
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Speciality | Clinic/Center |
Location | 255 Executive Dr Ste 210b, Plainview, New York |
Authorized Official Name and Position | David Kim (OWNER) |
Authorized Official Contact | 9177465942 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kim Medical Of New York Pllc 255 Executive Dr Ste 210b Plainview NY 11803-1711 Ph: () - | Kim Medical Of New York Pllc 255 Executive Dr Ste 210b Plainview NY 11803-1711 Ph: (833) 433-2273 |
NPI Number | 1770230039 |
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Provider Enumeration Date | 03/07/2022 |
Last Update Date | 02/08/2023 |
Medicare PECOS PAC ID | 6002299310 |
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Medicare Enrollment ID | O20221123000626 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770230039 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | David C Kim |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1558314781 PECOS PAC ID: 8921999269 Enrollment ID: I20040324000608 |
Provider Name | Vincent J Damore |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1174575666 PECOS PAC ID: 0244290989 Enrollment ID: I20041015000956 |
Provider Name | Vincent Campasano |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1881781979 PECOS PAC ID: 5496713398 Enrollment ID: I20041223000129 |
Provider Name | Kevin Munjal |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1720227440 PECOS PAC ID: 7416009865 Enrollment ID: I20090715000339 |
Provider Name | Stephen Andreoni |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1255444857 PECOS PAC ID: 0749334209 Enrollment ID: I20090818000420 |
Provider Name | Joseph A Zito |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1649441429 PECOS PAC ID: 1254455157 Enrollment ID: I20100830000588 |
Provider Name | Joseph Milano |
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Provider Type | Practitioner - Hospice/palliative Care |
Provider Identifiers | NPI Number: 1487884656 PECOS PAC ID: 3375668106 Enrollment ID: I20100916000357 |
Provider Name | Shannon L Henning |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1194037333 PECOS PAC ID: 2961645973 Enrollment ID: I20130823000314 |
Provider Name | Khawaja Siddique |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750636635 PECOS PAC ID: 0345556718 Enrollment ID: I20150831001354 |
Provider Name | Georgette Dixon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093145708 PECOS PAC ID: 9830586742 Enrollment ID: I20220425000105 |
Provider Name | Jaclyn Nicole Boggs |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184391088 PECOS PAC ID: 6103298401 Enrollment ID: I20230215000911 |
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