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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