Holmdel Medical Group, Inc

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

MA72196 Issued in NJ

Legal business name

HOLMDEL MEDICAL GROUP, INC

Practice address

100 Commons Way
Suite 701
Holmdel, NJ 07733-2934

Phone

(732) 796-0182

NPI assigned

Jun 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Chong S Kim

Title

President

Phone

(732) 796-0182

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114962297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COMMONS WAY",
            "address_2": "SUITE 701",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332934",
            "telephone_number": "732-796-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COMMONS WAY",
            "address_2": "SUITE 701",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332934",
            "telephone_number": "732-796-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLMDEL MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHONG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-796-0182",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NJ",
            "license": "MA72196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holmdel Cardiology Associates LLC
• Holmdel Eye Center LLC
• Holmdel Gastroenterology Associates
• Holmdel Health Center
• Holmdel Imaging LLC
• Holmdel Multi Specialty Surgical Associates LLC
• Holmdel Obstetrics & Gynecology Associates, PA
• Holmdel Ophthalmology LLC
• Holmdel Orthodontics LLC
• Holmdel Pediatrics, LLC

• Otolaryngology/Facial Plastic Surgery Physician in Holmdel, NJ
• Providers in Holmdel, NJ by specialty
• Otolaryngology/Facial Plastic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.