| Woo Sup Kim M D P C | |
|
9711 101st Ave Ozone Park NY 11416-2523 | |
| (718) 845-6000 | |
| Not Available |
| Full Name | Woo Sup Kim M D P C |
|---|---|
| Speciality | Clinic/Center |
| Location | 9711 101st Ave, Ozone Park, New York |
| Authorized Official Name and Position | Woo Sup Kim (D.R) |
| Authorized Official Contact | 7188456000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woo Sup Kim M D P C 9711 101st Ave Ozone Park NY 11416-2523 Ph: (718) 845-6000 | Woo Sup Kim M D P C 9711 101st Ave Ozone Park NY 11416-2523 Ph: (718) 845-6000 |
| NPI Number | 1104198878 |
|---|---|
| Provider Enumeration Date | 01/27/2012 |
| Last Update Date | 03/02/2012 |
| Medicare PECOS PAC ID | 0840457370 |
|---|---|
| Medicare Enrollment ID | O20120210000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104198878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 160493 (New York) | Primary |
| Provider Name | Woosup Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982769857 PECOS PAC ID: 3476634601 Enrollment ID: I20080114000744 |
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