Kim, Diane M.

Kim, Diane M. is an sole proprietor health care provider with primary practice located at 2151 Lemoine Ave. , Fort Lee NJ 07024. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Kim, Diane M. can be contacted via phone (201) 346-9000.

Contact Information

Primary practice address
2151 Lemoine Ave. Fort Lee NJ 07024
Phone: (201) 346-9000
Fax: (201) 346-9001
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TUV006818 New York
Eye and Vision Services Providers / Optometrist 152W00000X 270A00602800 New Jersey

Profile Details

NPI number 1710945589
LBN Legal business name Kim, Diane M.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 2nd, 2006
Last updated Dec 11th, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710945589 NPPES
New York MEDICAID 00244528
New York MEDICAID 0122874

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