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NPI 1457440356

NPI 1457440356 : CHRISTY KIM P.T. : WEST LONG BRANCH, NJ

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General NPI Number Information
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    NPI Number           |    1457440356
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTY KIM P.T.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/11/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    240 WALL ST 
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    City                 |    WEST LONG BRANCH
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    State                |    NJ
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    Zip                  |    07764-1181
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    Country              |    US
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    Telephone            |    732-222-8556
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    Fax                  |    732-222-8663
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Provider Business Mailing Address
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    Address Line         |    865 E 9TH ST 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11230-2809
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    Country              |    US
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    Telephone            |    718-692-4926
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    025555-1
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    License Number State |    NY
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