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General NPI Number Information
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NPI Number | 1316167539
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Entity Type | Individual
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Provider Name | GRACE J. KIM OTR
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Gender | Female
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 525 E 68TH ST
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City | NEW YORK
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State | NY
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Zip | 10065-4870
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Country | US
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Telephone | 212-746-1356
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Fax |
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Provider Business Mailing Address
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Address Line | 383 GRAND ST M1602
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City | NEW YORK
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State | NY
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Zip | 10002-3905
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Country | US
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Telephone | 917-657-2159
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 012501-1
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License Number State | NY
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