Organization
FUNCTIONAL NURSE PRACTITIONER IN FAMILY HEALTH
Active
Other names
Revive wellness
Organization subpart
No
Provider details
NPI number
Authorized official
HYUNCHU KIM GOLD NP (STAFF NURSE PRACTITIONER)
(917) 309-0729
Entity
Organization
Contact information
Practice address
2 W 32ND ST STE 602, NEW YORK, NY 10001-0602
(917) 309-0729
Mailing address
2 W 32ND ST STE 602, NEW YORK, NY 10001-0602
(917) 309-0729
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
06/25/2025
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