Individual
DR. EUNAE CHRISTINA KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
21150 45TH DR, BAYSIDE, NY 11361-3357
(718) 578-5242
Mailing address
1018 PALISADE AVE, APT # 3, FORT LEE, NJ 07024-6300
(718) 578-5242
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
001524
NY
103T00000X
Psychologist
017463
NY
103T00000X
Psychologist
Primary
35S100510500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001524
MENTAL HEALTH
NY
01
—
017463
PSYCHOLOGIST
NY
01
—
35S100510500
PSYCHOLOGY LICENSE
NJ
Enumeration date
04/03/2007
Last updated
11/05/2013
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