Individual
AUTUMN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 E 102ND ST, NEW YORK, NY 10029-0307
(212) 241-6500
Mailing address
10 E 102ND ST, NEW YORK, NY 10029-0307
(212) 241-6500
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
1111111
NY
207QA0505X
Adult Medicine Physician
Primary
111111
NY
207RP1001X
Pulmonary Disease Physician
111111
NY
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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