DR. RENEE ROSA KIM (NPI# 1184153561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184153561 |
| Entity Type | Individual |
| Full Name | DR. RENEE ROSA KIM |
| Credential | DMD |
| Practice Address |
789 Howard Ave New Haven CT 06510 |
| Mailing Address |
789 Howard Ave New Haven CT 06519-1304 |
| Practice Telephone | (203) 688-2464 |
| Mailing Telephone | 2036882464 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366845109 | Renee S. Kim | Acupuncturist | 8229 Boone Blvd Ste 402, Vienna, VA 22182-2623 | 2014-10-08 |
| 1124275516 | Renee Kim | Psychologist | 433 N Altadena Dr Unit 8, Pasadena, CA 91107-2558 | 2008-08-27 |
| 1770975831 | Renee Kim | Nurse Practitioner | 3295 N Arlington Heights Rd, Arlington Heights, IL 60004-1565 | 2015-02-26 |
| Street Address |
789 HOWARD AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558359752 | Rachel J Lampert | Internal Medicine | 789 Howard Ave, Dana Building -3 Rd Floor, New Haven, CT 06519-1304 | 2005-10-11 |
| 1104432996 | Elise Hettenbach | Nurse Practitioner | 789 Howard Ave, New Haven, CT 06519-1304 | 2020-09-17 |
| 1730794272 | Jennifer Colon | Pharmacist | 789 Howard Ave, New Haven, CT 06519-1300 | 2020-09-11 |
| 1366971293 | Nanthiya Sujijantarat | Student in an Organized Health Care Education/Training Program | 789 Howard Ave, New Haven, CT 06519-1304 | 2017-06-05 |
| 1033646492 | Fatimah Audu | Emergency Medicine | 789 Howard Ave, New Haven, CT 06519-1304 | 2017-05-16 |
| 1447787064 | Aaron David Bennett | Pediatrics | 789 Howard Ave, New Haven, CT 06519-1304 | 2017-05-13 |
| 1396289211 | Christopher Barrett | Dietitian, Registered | 789 Howard Ave, New Haven, CT 06519-1304 | 2016-12-12 |
| 1629427000 | Jesse Humm | Student in an Organized Health Care Education/Training Program | 789 Howard Ave, New Haven, CT 06519-1304 | 2016-06-07 |
| 1386092153 | Zehra Omer | Student in an Organized Health Care Education/Training Program | 789 Howard Ave, Ynhh, Dept of Medicine, New Haven, CT 06519-1304 | 2016-06-02 |
| 1144678004 | Daley Marie Ford-matz | Student in an Organized Health Care Education/Training Program | 789 Howard Ave, New Haven, CT 06519-1304 | 2016-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336757319 | Matthew Peter O'connell | Pharmacist | 55 Park Street, Lower Level, Department of Pharmacy, New Haven, CT 06510 | 2020-07-16 |
| 1477171460 | Huy Henry Le | Pharmacist | 20 York Street, Ps-ll, New Haven, CT 06510 | 2020-07-07 |
| 1144855263 | Daniel Jacobs | Student in an Organized Health Care Education/Training Program | 367 Cedar Street, Bldg. D, Student Affairs Office, New Haven, CT 06510 | 2020-03-09 |
| 1346898467 | Cem Cengiz | Internal Medicine | Tobb Etu Hastanesi, Yasam Cad. No.5 Sogutozu, Ankara, TURKEY 06510 | 2019-09-02 |
| 1295292290 | Emily Elizabeth Samuel | Counselor | 40 Temple Street, Ste 7c, Yale Child Outpatient Clinic, New Haven, CT 06510 | 2019-02-26 |
| 1639652779 | Laura Goldblum | Social Worker | 1450 Chapel Childrens Hospital, 1450 Chapel Street, New Haven, CT 06510 | 2018-09-14 |
| 1477049138 | Joseph Lawrence Earles | Otolaryngology | Yale Physicians Building, 800 Howard Ave., 4th Floor, New Haven, CT 06510 | 2018-07-06 |
| 1508356759 | Rebecca Anne Beagan | Student in an Organized Health Care Education/Training Program | 20 York Street- Pediatrics, New Haven, CT 06510 | 2018-05-14 |
| 1104316405 | Emma Sophie Taylor-salmon | Student in an Organized Health Care Education/Training Program | 20 York Street - Pediatrics, New Haven, CT 06510 | 2018-05-14 |
| 1376033563 | Wael S Ibrahim | Student in an Organized Health Care Education/Training Program | 20 York Street, Ynnh - Tompkins 226, New Haven, CT 06510 | 2018-05-14 |
| Find all providers in zip 06510 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861019689 | Mallori Wisuri | Student in an Organized Health Care Education/Training Program | 14505 Old 24 E, New Haven, IN 46774-9013 | 2020-06-27 |
| 1952920019 | Nazli Dizman | Student in an Organized Health Care Education/Training Program | 20 York St Tompkins 226, New Haven, CT 06510-3220 | 2020-04-09 |
| 1972132314 | Ross David Logan | Student in an Organized Health Care Education/Training Program | 20 York St Ste 226, New Haven, CT 06510-3220 | 2020-04-07 |
| 1194354043 | Christian Keene | Student in an Organized Health Care Education/Training Program | 625 Orange St Apt 43, New Haven, CT 06511-3840 | 2020-04-03 |
| 1639706146 | Kevin Jiang | Student in an Organized Health Care Education/Training Program | 330 Orchard St Ste 207, New Haven, CT 06511-4429 | 2020-03-25 |
| 1144855263 | Daniel Jacobs | Student in an Organized Health Care Education/Training Program | 367 Cedar Street, Bldg. D, Student Affairs Office, New Haven, CT 06510 | 2020-03-09 |
| 1275166407 | Joshua Braden | Student in an Organized Health Care Education/Training Program | 32277 Salt River Cir N, New Haven, MI 48048-3331 | 2020-02-17 |
| 1871125401 | Taylor Alexandra Babin | Student in an Organized Health Care Education/Training Program | 166 Hall St, New Haven, CT 06512-3148 | 2020-02-11 |
| 1952962649 | Su Jung Kim | Student in an Organized Health Care Education/Training Program | 111 Park St Apt 12t, New Haven, CT 06511-5421 | 2019-06-24 |
| 1144880691 | Durga Thakral | Student in an Organized Health Care Education/Training Program | 367 Cedar St Ste 317, New Haven, CT 06510-3222 | 2019-06-17 |
| Find all providers in NEW HAVEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.