Individual
SAMUEL KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
24904 34TH AVE, LITTLE NECK, NY 11363-1407
(646) 644-5509
Mailing address
24904 34TH AVE, LITTLE NECK, NY 11363-1407
(646) 644-5509
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006650
NY
Other
Enumeration date
12/08/2019
Last updated
12/08/2019
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