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General NPI Number Information
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NPI Number | 1023404019
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Entity Type | Individual
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Provider Name | ANNIE JUHAE KIM MD
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Gender | Female
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Dates
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Enumeration Date | 04/07/2015
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 877 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10075-0341
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Country | US
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Telephone | 646-798-8212
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Fax | 212-904-0980
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Provider Business Mailing Address
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Address Line | 1 NORTHSIDE PIERS APT 22H
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City | BROOKLYN
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State | NY
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Zip | 11249-3187
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Country | US
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Telephone | 646-798-8212
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Fax | 212-904-0980
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 299052
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License Number State | NY
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