Provider Demographics
NPI:1306155395
Name:KIM, HEEJIN MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:HEEJIN
Middle Name:MICHELLE
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:973-656-6280
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:8 SADDLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-1902
Practice Address - Country:US
Practice Address - Phone:973-267-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-25
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09788700207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine