Organization
BEACON CHRISTIAN COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HOI KIM MD (CEO)
(718) 815-6560
Entity
Organization
Contact information
Practice address
2079 FOREST AVE, STATEN ISLAND, NY 10303-1735
(718) 815-6560
(718) 815-6576
Mailing address
2079 FOREST AVE, STATEN ISLAND, NY 10303-1735
(718) 815-6560
(718) 815-6570
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
7004209R
NY
207R00000X
Internal Medicine Physician
7004209R
NY
207V00000X
Obstetrics & Gynecology Physician
7004209R
NY
208000000X
Pediatrics Physician
7004209R
NY
213E00000X
Podiatrist
7004209R
NY
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/29/2006
Last updated
04/07/2023
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