Susan Soojin Kim

Primary specialty

SpecialistTaxonomy code 174400000X

License

814951142 Issued in NY

Practice address

12 Sterling PL
1St FL
Edgewater, NJ 07020-1415

Phone

(212) 683-8905

NPI assigned

Jul 11, 2012

Last updated

Jan 23, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1538424080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 STERLING PL",
            "address_2": "1ST FL",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201415",
            "telephone_number": "201-888-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 STERLING PL",
            "address_2": "1ST FL",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201415",
            "telephone_number": "212-683-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUSAN",
        "middle_name": "SOOJIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "814951142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Yonmi Kim, DMD
• Minseong Kim
• Samuel Kim, DMD
• Sara Kim, PHARM.D.
• Scott Kim, DDS
• Yongkyung Kim
• Kimberly Physical Therapy Inc.
• Kinu Inc (Personal Care Professionals)
• Terri Klemm, LCSW
• Denada Kleyman, DDS

• Specialist in Edgewater, NJ
• Providers in Edgewater, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.