Individual
ELLY JINOK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 EAST 188TH STREET, BRONX, NY 10458-3817
(718) 618-8365
Mailing address
260 EAST 188TH STREET, BRONX, NY 10458-3817
(718) 618-8365
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F340386-1
NY
Other
Enumeration date
05/10/2016
Last updated
10/12/2016
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