Individual
MICHAEL JEFFREY KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPSYA
Contact information
Practice address
3016 31ST ST, ASTORIA, NY 11102-2269
(917) 202-7261
Mailing address
355 W 47TH ST APT 4RE, NEW YORK, NY 10036-2442
(917) 202-7261
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
000819
NY
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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