Kim, Kwang Ho

Kim, Kwang Ho is an individual health care provider with primary practice located at 1000 Montauk Hwy , West Islip NY 11795-4927. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Kim, Kwang Ho can be contacted via phone (631) 376-4088.

Contact Information

Primary practice address
1000 Montauk Hwy West Islip NY 11795-4927
Phone: (631) 376-4088
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 1875391 New York

Profile Details

NPI number 1528045242
LBN Legal business name Kim, Kwang Ho
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528045242 NPPES
New York MEDICAID 00472399

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