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Organization
NEAR ME DERMATOLOGY WEST SENECA PLLC
Active
Organization
NEAR ME DERMATOLOGY WEST SENECA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOUN JEA KIM FNP (OWNER)
(213) 880-2538
Entity
Organization
Contact information
Practice address
550 ORCHARD PARK RD STE 110, WEST SENECA, NY 14224-2646
(213) 880-2538
Mailing address
1170 MAPLE RD, WILLIAMSVILLE, NY 14221-3440
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04401649
—
NY
Enumeration date
08/30/2021
Last updated
08/30/2021
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