Individual
DR. IRENE E KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
22215 NORTHERN BLVD, BAYSIDE, NY 11361-3678
(718) 352-6093
Mailing address
222-15 NORTHERN BLVD, C1, BAYSIDE, NY 11361-2201
(718) 352-6093
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400787
NY
Other
Enumeration date
06/09/2008
Last updated
07/21/2022
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