Individual
DR. BRIAN S. IM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
240 E 38TH ST, 15TH FLOOR, ROOM 15-54, NEW YORK, NY 10016-2708
(212) 263-6110
(212) 263-6251
Mailing address
240 E 38TH ST, 15TH FLOOR, ROOM 15-54, NEW YORK, NY 10016-2708
(212) 263-6110
(212) 263-6251
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA08099200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107778
—
NJ
Enumeration date
09/11/2006
Last updated
04/12/2021
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