Individual
MS. JISOOK KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
59 OUTWATER LN, GARFIELD, NJ 07026-3825
(973) 253-0530
Mailing address
27 ELM PL, DEMAREST, NJ 07627-2630
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI02899800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6645909
—
NJ
Enumeration date
02/13/2008
Last updated
02/13/2008
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