Healthcare Provider Details

I. General information

NPI: 1952797474
Provider Name (Legal Business Name): JAMES INKYO RIM MD, JD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 04/25/2021
Certification Date: 04/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 RIVERSIDE DRIVE
NEW YORK NY
10032
US

IV. Provider business mailing address

1051 RIVERSIDE DRIVE
NEW YORK NY
10032
US

V. Phone/Fax

Practice location:
  • Phone: 646-774-6390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number286477
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: