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General NPI Number Information
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NPI Number | 1407494487
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Entity Type | Individual
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Provider Name | SEOHYUN KIM
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Gender | Female
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Dates
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Enumeration Date | 12/20/2019
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Last Update Date | 12/20/2019
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Provider Practice Location Address
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Address Line | 462 S MAIN ST
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-3031
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Country | US
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Telephone | 908-818-8351
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Fax |
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Provider Business Mailing Address
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Address Line | 416 W TILGHMAN ST
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City | ALLENTOWN
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State | PA
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Zip | 18102-2426
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Country | US
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Telephone | 610-351-1900
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP454117
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI04057300
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License Number State | NJ
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