Basic Information
| Provider Information | |||||||||
| NPI: | 1902224587 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KIM | ||||||||
| FirstName: | SAMUEL | ||||||||
| MiddleName: | M | ||||||||
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| Mailing Information | |||||||||
| Address1: | WEILL CORNELL MEDICINE DIVISION OF CARDIOLOGY | ||||||||
| Address2: | 1305 YORK AVENUE 8TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100215663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6469625558 | ||||||||
| FaxNumber: | 6469620050 | ||||||||
| Practice Location | |||||||||
| Address1: | WEILL CORNELL MEDICINE DIVISION OF CARDIOLOGY | ||||||||
| Address2: | 520 EAST 70TH STREET, STARR PAVILION 4TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100210010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6469625558 | ||||||||
| FaxNumber: | 6469620050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2014 | ||||||||
| LastUpdateDate: | 08/13/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207UN0901X | 288447 | NY | N | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | 207RC0000X | 288447 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.