Kang Kiel Kim MD PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

111678 Issued in NY

Legal business name

KANG KIEL KIM MD PC

Practice address

1 Webster Ave
Suite 307
Poughkeepsie, NY 12601-1361

Phone

(845) 471-1002

Fax

(845) 471-1003

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kang Kiel Kim, MD

Title

President

Phone

(845) 471-1002

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790823466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WEBSTER AVE",
            "address_2": "SUITE 307",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011361",
            "telephone_number": "845-471-1002",
            "fax_number": "845-471-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WEBSTER AVE",
            "address_2": "SUITE 307",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011361",
            "telephone_number": "845-471-1002",
            "fax_number": "845-471-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANG KIEL KIM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KANG",
        "authorized_official_middle_name": "KIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-471-1002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "111678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00538156",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krishna Kallakuri, MD
• Robert G. Kammerman, MD
• Sulada Kanchana, M.D.
• Ramamohana R. Kancherla, M.D.
• Nancy Kanetzky, MSW
• Marta Kania, DMD
• Yazholi Kanikkannan, MD
• Diane Kantaros, MD
• Louis W Kantaros, MD FACC
• Ami B Kaplan, LCSW

• Surgery Physician in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Surgery Physician in New York

• 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.