Individual
MR. TAESOO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1396 MYRTLE AVE, BROOKLYN, NY 11237-4513
(718) 878-4314
Mailing address
3279 30TH ST APT 3G, ASTORIA, NY 11106-2971
(732) 570-7757
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
015595
NY
Other
Enumeration date
05/15/2012
Last updated
02/16/2015
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