Individual
BRIAN SHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2217 120TH ST, COLLEGE POINT, NY 11356-2517
(516) 234-2618
Mailing address
2217 120TH ST, COLLEGE POINT, NY 11356-2517
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310349
NY
Other
Enumeration date
03/07/2013
Last updated
03/07/2013
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