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General NPI Number Information
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NPI Number | 1235095910
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Entity Type | Individual
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Provider Name | MICHELLE KIM MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 1723 ELM AVE
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City | BROOKLYN
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State | NY
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Zip | 11230-5306
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Country | US
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Telephone | 516-413-5102
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Fax | 718-425-0501
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Provider Business Mailing Address
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Address Line | 19919 23RD AVE
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City | WHITESTONE
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State | NY
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Zip | 11357-4123
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Country | US
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Telephone | 516-413-5102
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Fax | 718-425-0501
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 024155
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License Number State | NY
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