Organization
BEACON CHRISTIAN COMMUNITY HEALTH CENTER, INC.
Active
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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