Individual
DR. KUMOCK KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20837 32ND AVE, BAYSIDE, NY 11361-1042
(718) 614-4565
(718) 423-0150
Mailing address
20837 32ND AVE, BAYSIDE, NY 11361-1042
(718) 614-4565
(718) 423-0150
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
126538-1
NY
2084P0804X
Child & Adolescent Psychiatry Physician
126538-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00236044
—
NY
Enumeration date
02/20/2008
Last updated
03/06/2008
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