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General NPI Number Information
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NPI Number | 1235507641
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Entity Type | Individual
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Provider Name | ALICE EUN KIM L.AC
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Gender | Female
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 2707 MARYANNES CT
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City | NORTH WALES
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State | PA
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Zip | 19454-2021
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Country | US
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Telephone | 917-592-7644
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Fax |
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Provider Business Mailing Address
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Address Line | 134 W 26TH ST SUITE 903
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City | NEW YORK
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State | NY
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Zip | 10001-6803
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Country | US
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Telephone |
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 005433-1
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License Number State | NY
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