Individual
JIMYEONG SON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 COMMUNITY DR, MANHASSET, NY 11030-3815
(833) 454-8377
Mailing address
400 COMMUNITY DR, MANHASSET, NY 11030-3815
(516) 472-5800
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1557056
NY
Other
Enumeration date
02/16/2022
Last updated
07/16/2022
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