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General NPI Number Information
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NPI Number | 1457234866
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Entity Type | Individual
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Provider Name | JUDY KIM
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Gender | Female
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 2346 TRENTON RD STE C
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City | LEVITTOWN
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State | PA
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Zip | 19056-1445
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Country | US
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Telephone | 215-945-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 105 GUILFORD CT
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City | NORTH WALES
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State | PA
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Zip | 19454-4211
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Country | US
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Telephone | 267-515-9143
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | OA007351
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License Number State | PA
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