Healthcare Provider Details

I. General information

NPI: 1790306538
Provider Name (Legal Business Name): HYOMIN LIM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date: 01/11/2022
Reactivation Date: 03/22/2022

III. Provider practice location address

8900 VAN WYCK EXPY
RICHMOND HILL NY
11418-2832
US

IV. Provider business mailing address

1400 PELHAM PARKWAY SOUTH JACOBI MEDICAL CENTER
BRONX NY
10461
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number341294
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number341294
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: