Individual
HAE OK KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(201) 820-7296
Mailing address
3020 EDWIN AVE APT 1C, FORT LEE, NJ 07024-3414
(201) 820-7296
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ00601400
NJ
Other
Enumeration date
11/19/2015
Last updated
08/06/2020
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