Kim, Ae Chan
Kim, Ae Chan is an sole proprietor health care provider with primary practice located at 43 Tweed Blvd , Nyack, NY 10960. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Kim, Ae Chan can be contacted via phone (845) 634-1799.Contact Information
Primary practice address
43 Tweed Blvd
Nyack, NY 10960
Phone: (845) 634-1799
Fax: (845) 358-6604
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 117579 | New York |
Profile Details
| NPI number | 1992896674 |
|---|---|
| LBN Legal business name | Kim, Ae Chan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992896674 | NPPES |
| New York | Other | 117579 | LICENSE |
| New York | MEDICAID | 00218277 | LICENSE |
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