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General NPI Number Information
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NPI Number | 1053232256
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Entity Type | Organization
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Legal Business Name | MINT MEDICAL PLLC
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 1441 BROADWAY RM 2403
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City | NEW YORK
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State | NY
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Zip | 10018-0101
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Country | US
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Telephone | 212-201-1043
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 BROADWAY RM 2403
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City | NEW YORK
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State | NY
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Zip | 10018-0101
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Country | US
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Telephone | 212-201-1043
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | HARIM KIM
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Credential | MD
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Telephone | 781-382-4460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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