Healthcare Provider Details

I. General information

NPI: 1720426257
Provider Name (Legal Business Name): KOREAN COMMUNITY SERVICES OF METROPOLITAN NEW YORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20305 32ND AVE
BAYSIDE NY
11361-1021
US

IV. Provider business mailing address

20305 32ND AVE
BAYSIDE NY
11361-1021
US

V. Phone/Fax

Practice location:
  • Phone: 718-939-6137
  • Fax: 718-886-6126
Mailing address:
  • Phone: 718-939-6137
  • Fax: 718-886-6126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MYOUNGMI KIM
Title or Position: EXECUTIVE VICE PRESIDENT
Credential: MPH
Phone: 718-939-6137