Dae Un Kim, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

25MA02683700 Issued in NJ

Practice address

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Phone

(973) 322-5763

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1225110034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66689",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041056689",
            "telephone_number": "866-689-8862",
            "fax_number": "207-347-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAE",
        "middle_name": "UN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA02683700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2503107",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yan Kharkover, DPT
• Victoria Khavulya, PHARM.D
• Yelena Khmelnitsky, PAC
• Kids & Family Dentistry
• Leslie Killeen, R.D.
• Jenny Hyunjung Kim, M.D.
• Jeong Eun Kim, M.D.
• Jennifer Kinchen-Mason
• John Kindzierski III, MD
• Ayana King

• Anatomic Pathology & Clinical Pathology Physician in Livingston, NJ
• Providers in Livingston, NJ by specialty
• Anatomic Pathology & Clinical Pathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.