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General NPI Number Information
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NPI Number | 1316000698
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Entity Type | Individual
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Provider Name | LAURA SOOK KIM M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 11205 QUEENS BLVD
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City | FOREST HILLS
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State | NY
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Zip | 11375-8311
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Country | US
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Telephone | 718-670-2309
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Fax | 347-394-5587
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Provider Business Mailing Address
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Address Line | 11205 QUEENS BLVD
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City | FOREST HILLS
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State | NY
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Zip | 11375-8311
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Country | US
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Telephone | 718-670-2309
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Fax | 347-394-5587
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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 | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 25MA08131400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 25MA08131400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 235733
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 235733
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License Number State | NY
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