Healthcare Provider Details

I. General information

NPI: 1225531924
Provider Name (Legal Business Name): YUJI KIM ACUPUNCTURIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2018
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date: 08/30/2023
Reactivation Date: 08/21/2025

III. Provider practice location address

30 W 60TH ST APT 1N
NEW YORK NY
10023-7906
US

IV. Provider business mailing address

30 W 60TH ST APT 1N
NEW YORK NY
10023-7906
US

V. Phone/Fax

Practice location:
  • Phone: 917-601-8647
  • Fax:
Mailing address:
  • Phone: 917-601-8647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number6174
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number312618
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: