Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 25MA10410600 | NJ |
NPI | 1356667158 |
---|---|
Provider Name | Joseph Jongbum Kim |
First Address | Berkeley Heights, NJ 07922-2104 |
Second Address | Florham Park, NJ 07932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 31/10/2018 |