Provider Demographics
NPI:1871736256
Name:KIM, JONG HYUN (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JONG
Middle Name:HYUN
Last Name:KIM
Suffix:
Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:158 LINWOOD PLZ
Mailing Address - Street 2:ROOM 208-10 : JONG H.KIM,MD'S PAIN & REHAB CENTER PC
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3761
Mailing Address - Country:US
Mailing Address - Phone:201-346-4347
Mailing Address - Fax:
Practice Address - Street 1:158 LINWOOD PLZ
Practice Address - Street 2:ROOM 208-10 : JONG H.KIM,MD'S PAIN & REHAB CENTER PC
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-3761
Practice Address - Country:US
Practice Address - Phone:201-346-4347
Practice Address - Fax:201-346-3950
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2019-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09332600208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ403571Medicaid
NJ318990PWSMedicare PIN