Kim, Sung Jo

Kim, Sung Jo is an individual health care provider with primary practice located at 260 Patchogue Yaphank Rd Ste F, East Patchogue NY 11772-4886. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Kim, Sung Jo can be contacted via phone (631) 654-8755.

Contact Information

Primary practice address
260 Patchogue Yaphank Rd Ste F East Patchogue NY 11772-4886
Phone: (631) 654-8755
Fax: (631) 654-8709
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 121585 New York

Profile Details

NPI number 1477538908
LBN Legal business name Kim, Sung Jo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated Apr 28th, 2008 - about 16 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 1477538908 NPPES
Other W38231 MEDICARE GROUP NUMBER
MEDICAID 00228217 MEDICARE GROUP NUMBER

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