Healthcare Provider Details

I. General information

NPI: 1336939560
Provider Name (Legal Business Name): MS. BELLA K YIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1873 86TH ST FL 1
BROOKLYN NY
11214-3108
US

IV. Provider business mailing address

2333 85TH ST FL 1
BROOKLYN NY
11214-3403
US

V. Phone/Fax

Practice location:
  • Phone: 646-821-2301
  • Fax:
Mailing address:
  • Phone: 646-821-2301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number033876-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: