Healthcare Provider Details

I. General information

NPI: 1649036195
Provider Name (Legal Business Name): SBK CHIROPRACTIC P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 MADISON AVE RM 601
NEW YORK NY
10016-0719
US

IV. Provider business mailing address

274 MADISON AVE RM 601
NEW YORK NY
10016-0719
US

V. Phone/Fax

Practice location:
  • Phone: 929-637-6529
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. SANG BUM KIM
Title or Position: OWNER
Credential: DC
Phone: 929-637-6529