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General NPI Number Information
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NPI Number | 1245802081
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Entity Type | Organization
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Legal Business Name | CK NP PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 250 N 10TH ST APT 333
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City | BROOKLYN
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State | NY
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Zip | 11211-2822
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Country | US
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Telephone | 347-855-4192
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Fax | 646-760-6584
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Provider Business Mailing Address
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Address Line | 244 5TH AVE STE K231
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City | NEW YORK
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State | NY
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Zip | 10001-7604
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Country | US
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Telephone | 347-855-4192
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Fax | 646-760-6584
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | MS. CRYSTAL KIM
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Credential | NP
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Telephone | 347-855-4192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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