Individual
BYEONGJIK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
194 BUCKLAND HILLS DR, MANCHESTER, CT 06042-8705
(860) 644-0099
Mailing address
194 BUCKLAND HILLS DR, MANCHESTER, CT 06042-8705
(860) 644-0099
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GD60840B
—
NY
Enumeration date
04/28/2021
Last updated
04/28/2021
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