Individual
JEONG HI KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14648 23RD AVE, WHITESTONE, NY 11357-3514
(718) 359-3454
Mailing address
14648 23RD AVE, WHITESTONE, NY 11357-3514
(718) 359-3454
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
598886
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F307415
NY
Other
Enumeration date
12/26/2014
Last updated
09/10/2015
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