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General NPI Number Information
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NPI Number | 1285640730
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Entity Type | Individual
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Provider Name | JOSEPH Y SHIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5650 FRANCIS LEWIS BLVD FL 1
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City | OAKLAND GARDENS
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State | NY
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Zip | 11364-1635
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Country | US
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Telephone | 718-279-8107
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Fax | 718-279-8101
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Provider Business Mailing Address
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Address Line | 5650 FRANCIS LEWIS BLVD FL 1
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City | OAKLAND GARDENS
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State | NY
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Zip | 11364-1635
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Country | US
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Telephone | 718-279-8107
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Fax | 718-279-8101
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 213823
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License Number State | NY
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