Healthcare Provider Details

I. General information

NPI: 1396605580
Provider Name (Legal Business Name): EVELYN YIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 UNIVERSITY PL FL 9
NEW YORK NY
10003-4528
US

IV. Provider business mailing address

99 UNIVERSITY PL FL 9
NEW YORK NY
10003-4528
US

V. Phone/Fax

Practice location:
  • Phone: 212-604-1316
  • Fax: 212-604-1320
Mailing address:
  • Phone: 212-604-1316
  • Fax: 212-604-1320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number054672
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: