DR. CHANG SOO KIM (NPI# 1891719860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891719860 |
| Entity Type | Individual |
| Full Name | DR. CHANG SOO KIM |
| Credential | M.D. |
| Practice Address |
999 Summer St Stamford CT 06905-5546 |
| Practice Telephone | 2039201444 |
| Practice Fax Number | 8669205178 |
| Mailing Telephone | 2039201444 |
| Mailing Fax Number | 8669205178 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2017-03-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | 048229 | CT | Allopathic & Osteopathic Physicians |
| N | 208200000X | Plastic Surgery | 25MA07582400 | NJ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215149554 | Chang Soo Kim | Family Medicine | 3590 Peachtree Industrial Blvd, Duluth, GA 30096-4817 | 2007-05-07 |
| 1699797449 | Chang Soo Kim | Internal Medicine | 16420 East 9 Mile Rd, Eastpointe, MI 48021-2442 | 2006-07-24 |
| Street Address |
999 SUMMER ST |
| City | STAMFORD |
| State | CT |
| Zip Code | 06905-5546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609856020 | James Tulacro | Physician Assistant | 999 Summer St, 304, Stamford, CT 06905-5546 | 2006-01-20 |
| 1598222119 | Lubna Latif | Physician Assistant | 999 Summer St, Stamford, CT 06905-5546 | 2019-03-01 |
| 1750815098 | Mary Coppolo | Nurse Practitioner | 999 Summer St, Suite 304, Stamford, CT 06905-5546 | 2017-04-13 |
| 1578937579 | Integrative Medical Solutions, PC | Physical Medicine & Rehabilitation | 999 Summer St, Suite 205, Stamford, CT 06905-5546 | 2015-11-15 |
| 1700256708 | Big Leaps | Occupational Therapist | 999 Summer St, Suite 104, Stamford, CT 06905-5546 | 2015-10-02 |
| 1346649589 | Mark J. Ostrowski, Psy.d. LLC | Psychologist | 999 Summer St, Suite 200, Stamford, CT 06905-5546 | 2014-08-13 |
| 1962849091 | Comprehensive Neurology and Pain Center of Connecticut (stamford) | Pain Medicine | 999 Summer St, Suite 100, Stamford, CT 06905-5546 | 2013-05-30 |
| 1013263847 | Connecticut Skin Institute | Dermatology | 999 Summer St, Suite 205, Stamford, CT 06905-5546 | 2012-07-30 |
| 1033472568 | Shimrat R Notik | Dermatology | 999 Summer St, Ste 305, Stamford, CT 06905-5513 | 2012-06-19 |
| 1306156385 | Danielle Mckay | Occupational Therapy Assistant | 999 Summer St, Suite 104, Stamford, CT 06905-5546 | 2010-10-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396367272 | Smartport LLC | Non-emergency Medical Transport (VAN) | C/o Mollo, 1111 Summer St, Stamford, CT 06905 | 2020-05-13 |
| 1245889096 | Anna Diamantis | Counselor | 1200 High Ridge Road, 2nd Floor, Stamford, CT 06905 | 2019-09-04 |
| 1871150409 | Connecticut Anesthesia Associates LLC | Anesthesiology | 1177 High Ridge Road, Stamford, CT 06905 | 2019-05-20 |
| 1518447887 | Alexandra Petrov | Lactation Consultant, Non-RN | 42 Riverside Ave, Stamford, CT 06905 | 2018-08-16 |
| 1235640327 | A&s Chemists LLC | Pharmacy | 910 Summer Ave, Stamford, CT 06905 | 2017-10-17 |
| 1659805117 | Evolution Physical Therapy, LLC | Clinic/Center | 7 Reynolds Ave, Stamford, CT 06905 | 2017-04-11 |
| 1326587841 | Karen Poggi | Speech-Language Pathologist | 30 Buxton Farm Rd., Suite 230, Stamford, CT 06905 | 2017-02-16 |
| 1811434871 | Christina Skuburids, LLC | Point of Service | 2043 Bedford Street, Stamford, CT 06905 | 2017-01-27 |
| 1669833513 | Christian Alvarez | Occupational Therapist | 15 First St Unit 1, Stamford, CT 06905 | 2016-03-18 |
| 1932500915 | Emily Krol | Psychologist | 29 Yale Court, Stamford, CT 06905 | 2014-09-10 |
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| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669550851 | Harold S Gewirtz | Plastic Surgery | 70 Mill River Street, Stamford, CT 06902 | 2006-11-02 |
| 1366741217 | Julie Vasile, M.d. LLC | Plastic Surgery | 1290 Summer St, Suite 3200, Stamford, CT 06905-5360 | 2011-03-17 |
| 1568770428 | Gold Coast Plastic Surgery and Laser Center, LLC | Plastic Surgery | 999 Summer St, Suite 401, Stamford, CT 06905-5546 | 2010-09-14 |
| 1225135643 | Arthur R Rosenstock Md PC | Plastic Surgery | 1290 Summer St, Suite 3100, Stamford, CT 06905 | 2006-09-20 |
| 1043317464 | Estheriane Aesthetics Inc | Plastic Surgery | 1290 Summer St, Suite 3100, Stamford, CT 06905 | 2006-09-20 |
| 1881667392 | Leif O Nordberg | Plastic Surgery | 2001 W Main St, Suite 150, Stamford, CT 06902 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720642762 | Riverview Emergency Services LLC | Plastic Surgery | 148 East Ave Ste 3h, Norwalk, CT 06851-5726 | 2019-04-25 |
| 1073177184 | Laurel Chandler Md Pllc | Plastic Surgery | 195 Danbury Rd Ste 203, Wilton, CT 06897-4075 | 2019-04-24 |
| 1285080416 | Plastic Surgery Practice of Connecticut | Plastic Surgery | 44 Amogerone Crossway # 8151, Greenwich, CT 06830-9993 | 2016-05-06 |
| 1275997975 | Peau | Plastic Surgery | 1472 Boston Post Rd, Darien, CT 06820-5909 | 2016-04-08 |
| 1356684112 | Joseph Lopez | Plastic Surgery | 330 Cedar St Ste 330, New Haven, CT 06510-3218 | 2013-03-30 |
| 1881956514 | Mid State Md, LLC | Plastic Surgery | 85 Church St Ste 500, Middletown, CT 06457-3647 | 2012-06-08 |
| 1134356959 | Yuen-jong Liu | Plastic Surgery | 722 Post Rd Ste 200, Darien, CT 06820 | 2009-06-18 |
| 1407018419 | Julia Marie Toto | Plastic Surgery | University Physicians, 263 Farmington Avenue, Farmington, CT 06030 | 2008-06-30 |
| 1376704353 | Christopher David Hughes | Plastic Surgery | 399 Farmington Ave Ste 210, Farmington, CT 06032-1944 | 2008-06-22 |
| 1659546323 | Richard Restifo, Md PC | Plastic Surgery | 200 S Orange Center Rd, Orange, CT 06477-3349 | 2008-04-24 |
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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.