MEDICARE: IN KIM L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	007810	NY

General Provider Information

NPI Number	:	1760341556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IN KIM L.AC.

Provider Business Mailing Address
First Line	:	84 PALMER DR
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-2661
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	84 PALMER DR
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-2661
Country	:	US
Telephone Number	:	607-592-2026
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ IN KIM L.AC.” Practice Location

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