Individual
KYUNG WOON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3959 BROADWAY # 4C-408, NEW YORK, NY 10032-1559
(212) 305-5437
Mailing address
3959 BROADWAY # 4C-408, NEW YORK, NY 10032-1559
(212) 305-5437
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
679634
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
382610
NY
Other
Enumeration date
03/22/2016
Last updated
04/10/2020
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