SANG W KIM (NPI# 1548434236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548434236 |
| Entity Type | Individual |
| Full Name | SANG W KIM |
| Credential | MD |
| Practice Address |
4939 Brittonfield Pkwy Building B, Suite 210 East Syracuse NY 13057-9208 |
| Practice Telephone | 3154718404 |
| Practice Fax Number | 3154716803 |
| Mailing Telephone | 3154718404 |
| Mailing Fax Number | 3154716803 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2014-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
273922 | NY | Allopathic & Osteopathic Physicians |
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
273922 | NY | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03855896 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598165748 | Sang Kim | Acupuncturist | 19900 Fisher Ave, Poolesville, MD 20837-2077 | 2014-08-25 |
| 1245527340 | Sang Yup Kim | Podiatrist | 5451 La Palma Ave Ste 26, La Palma, CA 90623-1730 | 2011-07-09 |
| 1649570755 | Sang Wan Kim | Internal Medicine | 7305 Brookview Rd Unit 306, Elkridge, MD 21075-6080 | 2010-10-25 |
| 1538335484 | Sang Yoon Kim | Dentist | 2 Perlman Dr Ste 105, Spring Valley, NY 10977-5230 | 2008-05-01 |
| 1467593236 | Sang K Kim | Acupuncturist | 430 S Western Ave, #102a, Los Angeles, CA 90020-4176 | 2007-02-12 |
| 1689760415 | Sang C. Kim | Dentist | 344 Morris Ave S, Renton, WA 98057-2521 | 2006-10-05 |
| 1568494367 | Sang You Kim | General Practice | 14273 Ruby Glen Ct, Chino Hills, CA 91709-5915 | 2006-07-06 |
| 1023054202 | Sang H Kim | Internal Medicine | 1086 N Broadway Ste 240, Yonkers, NY 10701-1115 | 2006-06-22 |
| 1205885217 | Sang Cheul Kim | Obstetrics & Gynecology | 3340 West Ball Rd, #d, Anaheim, CA 92804 | 2006-05-08 |
| 1538133723 | Sang W Kim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3577 W Thirteen Mile Rd, #301, Royal Oak, MI 48073 | 2006-02-14 |
| Street Address |
4939 BRITTONFIELD PKWY BUILDING B, SUITE 210 |
| City | EAST SYRACUSE |
| State | NY |
| Zip Code | 13057-9208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205364940 | Michael Fiacco | Family Medicine | 4939 Brittonfield Pkwy, East Syracuse, NY 13057-9208 | 2017-05-25 |
| 1306394713 | Margaret Gambee Sweet | Physician Assistant | 4939 Brittonfield Pkwy, Suite 202, East Syracuse, NY 13057-9208 | 2016-09-14 |
| 1265823306 | Stacey Michelle Cook | Physician Assistant | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057-9208 | 2015-02-11 |
| 1659702314 | Lyndsay Raasch | Physician Assistant | 4939 Brittonfield Pkwy, Bldg B., Ste. 210, East Syracuse, NY 13057-9208 | 2013-12-06 |
| 1265869648 | Kevin James Smith | Physician Assistant | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057-9208 | 2013-10-01 |
| 1730443003 | Anthony John Malvasi | Family Medicine | 4939 Brittonfield Pkwy, East Syracuse, NY 13057-9208 | 2012-07-01 |
| 1518292333 | Theresa Mary Lucason | Physician Assistant | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057-9208 | 2009-10-13 |
| 1376788588 | Amy Lynn Russell | Physician Assistant | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057 | 2008-12-03 |
| 1578718730 | Stephanie Anne Clapper | Family Medicine | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057-9208 | 2008-12-01 |
| 1588819734 | James L Tarala | Family Medicine | 4939 Brittonfield Pkwy, Suite 101, East Syracuse, NY 13057-9208 | 2008-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891335527 | Amanda Christian | Clinic/Center | Hcr Home Care- 6007 Fair Lakes Rd, East Syracuse, NY 13057 | 2020-01-10 |
| 1437690104 | Wojtyna Dental LLC | Dentist | 6600 Weighlock Drive, East Syracuse, NY 13057 | 2017-03-15 |
| 1538609854 | Marie Elena Dow | Health Educator | 6576 Kirkville Road, East Syracuse, NY 13057 | 2017-03-06 |
| 1821534470 | Maureen Lanious | Massage Therapist | 6701 Manlius Center Road, Avanti Healing Arts, East Syracuse, NY 13057 | 2017-01-06 |
| 1629526058 | A Woman's Resource | Home Health | 5860 Bowman Road, East Syracuse, NY 13057 | 2016-09-14 |
| 1386029221 | Apollo Physical Therapy, Pllc | Physical Therapist | 6304 Carrier Parkway, East Syracuse, NY 13057 | 2015-07-21 |
| 1457734386 | Podiatry Services of Central New York, PC | Podiatrist | 6647 Kirkville Road, East Syracuse, NY 13057 | 2015-07-09 |
| 1730592163 | Plev Bc Plc | Dentist | 6600 Weighlock Dr, East Syracuse, NY 13057 | 2014-06-03 |
| 1821418740 | Kelsey Spradlin | Speech-Language Pathologist | 6400 Fremont Rd, East Syracuse, NY 13057 | 2014-04-17 |
| 1992044945 | Sizewise Rentals | Durable Medical Equipment & Medical Supplies | 6504 Basile Rowe, East Syracuse, NY 13057 | 2013-02-12 |
| Find all providers in zip 13057 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245524370 | Jason Brian Wasserman | Otolaryngology | 210 - 33 26th Ave, Ground Level, Bayside, NY 11360-1949 | 2011-06-06 |
| 1841591765 | Jack Martin Shapiro | Otolaryngology | 147 Bacon Rd, Old Westbury, NY 11568 | 2010-11-09 |
| 1831341643 | Krishnakumar Thankappan | Otolaryngology | Dept of Head and Neck Roswell Park Cancer, Elm and Carlton Streets, Buffalo, NY 14263-0001 | 2008-10-13 |
| 1235292855 | George J Braun | Otolaryngology | 38 E 38th St, New York, NY 10016-2505 | 2006-12-18 |
| 1811942220 | Oleh Slupchynskyj | Otolaryngology | 44 E 65th St, 1a, New York, NY 10021-7022 | 2006-05-23 |
| 1346629110 | Steven Andrew Gordon | Otolaryngology | 550 First Ave, Nyu Langone Medical Center, New York, NY 10016 | 2015-05-26 |
| 1043698608 | Nyc Metro Ent PC | Otolaryngology | 6273 Woodhaven Blvd, Rego Park, NY 11374-2832 | 2015-05-14 |
| 1396163747 | Ashley Paige O'connell Ferster | Otolaryngology | 2365 S Clinton Ave Ste 200, Rochester, NY 14618-2663 | 2014-04-02 |
| 1275824856 | Eric William Cerrati | Otolaryngology | 550 First Avenue, Nyu Langone Medical Center, New York, NY 10016 | 2011-04-29 |
| 1184858458 | Paul Raymond Young | Otolaryngology | 4955 N Bailey Ave, Suite 202, Amherst, NY 14226-1206 | 2009-05-14 |
| Find all providers with the same taxonomy | ||||
| City | EAST SYRACUSE |
| Zip Code | 13057 |
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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.