Organization
NEAR ME DERMATOLOGY PLLC
Active
Organization
NEAR ME DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOUN JEA KIM FNP (CHAIRMAN OF THE BOAD)
(213) 880-2538
Entity
Organization
Contact information
Practice address
550 ORCHARD PARK RD STE A110, WEST SENECA, NY 14224-2646
(716) 650-5720
(716) 650-4618
Mailing address
1170 MAPLE RD, WILLIAMSVILLE, NY 14221-3440
(213) 880-2538
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04401649
—
NY
Enumeration date
07/28/2021
Last updated
05/01/2024
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