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Contact Information

DAEGYUN KIM, PT, LAC
1581 ROUTE 27 UNIT 3
EDISON, NJ08817-3477
 Phone: 732-287-1990
 Fax: 732-287-1996
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Acupuncturist

171100000X
Indicates primary specialty

NPI Profile & details for DAEGYUN KIM · (Male)

NPI Number 1669404323
Status Active
Credentials PT, LAC
Entity Individual
Enumeration date 07/06/2006
Last updated 03/05/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 25MZ00040500
  • NJ License # 40QA01140100
  • NY License # 017470
  • NY Medicaid 02646413
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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