Provider Demographics
NPI:1992905533
Name:KIM, ROBERT BYRON (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BYRON
Last Name:KIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14021 32ND AVE
Mailing Address - Street 2:SUITE C1
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2613
Mailing Address - Country:US
Mailing Address - Phone:718-224-1600
Mailing Address - Fax:
Practice Address - Street 1:14021 32ND AVE
Practice Address - Street 2:SUITE C1
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2613
Practice Address - Country:US
Practice Address - Phone:718-224-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265993207LP2900X
CAFK2524797207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine