Type | Person | [sources] | |||
---|---|---|---|---|---|
Name | KIM STANLEY-SANGWOOK DO · Stanley Sangwook Kim DO | [sources] | |||
Birth date | not available | [sources] | |||
Nationality | not available | [sources] | |||
Country | United States of America | [sources] | |||
First name | Stanley | [sources] | |||
ID Number | 00238366 · OS014227 | [sources] | |||
Last name | Kim | [sources] | |||
Middle name | Sangwook | [sources] | |||
NPI | 1902815087 | [sources] | |||
Sector | Physician | [sources] | |||
Title | DO | [sources] | |||
Address | Out of State, Out of State | [sources] | |||
Last change | Last processed | First seen |
Medical providers deemed ineligible to participate in New York State's Medicaid program.
United States of America · OMIG
Medical providers who are precluded from participation in the Medical Assistance Program
United States of America · DHS
us-medpa-c1281bc29c2a398de3118ca63b31773d3a8b76d5
· us-medny-bf393259ac633af42ee0039ebdab853a39ca2684
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Sanctions | |||||
---|---|---|---|---|---|
Country | Authority | Program | Start date | End date | |
United States of America | Department of Human Services | - |
Address | ||
---|---|---|
Full address | Country | |
Out of State, Out of State | United States of America |
United States of America | New York State Office of the Medicaid Inspector General | - | - |