Individual
ETHAN YOOSEOK KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3925 BELL BLVD, BAYSIDE, NY 11361-2060
(718) 279-2020
Mailing address
4528 220TH PL, BAYSIDE, NY 11361-3647
(929) 369-7211
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
RT009892
NY
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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