Individual
JESSICA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
224 WALL ST STE 101, HUNTINGTON, NY 11743-2186
(631) 351-2024
Mailing address
224 WALL ST STE 101, HUNTINGTON, NY 11743-2186
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
311107
NY
Other
Enumeration date
12/12/2022
Last updated
12/12/2022
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