Individual
MS. JIYOON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
425 E 61ST ST FL 10, WEILL CORNELL BREAST CENTER, NEW YORK, NY 10065-8722
(646) 772-8109
Mailing address
24117A OAK PARK DR, DOUGLASTON, NY 11362-2611
(646) 772-8109
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
010657-1
NY
Other
Enumeration date
02/06/2007
Last updated
07/14/2016
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