Provider Demographics
NPI:1679831739
Name:KIM, MARIA BATRAKI (DO)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:BATRAKI
Last Name:KIM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 ROUTE 27
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1300
Mailing Address - Country:US
Mailing Address - Phone:732-940-5511
Mailing Address - Fax:
Practice Address - Street 1:1950 STATE ROUTE 27 STE HH
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1300
Practice Address - Country:US
Practice Address - Phone:732-940-5511
Practice Address - Fax:732-940-0530
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09004200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics