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Individual

MS. NANCY KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, PT

Contact information

Practice address
117 SHOREWARD DR, GREAT NECK, NY 11021-2514
(516) 472-0121
Mailing address
117 SHOREWARD DR, GREAT NECK, NY 11021-2514
(516) 472-0121

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
015166-1
NY

Other

Enumeration date
07/17/2010
Last updated
07/17/2010
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