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NPI 1528193596

NPI 1528193596 : JINYEON KIM : EAST MEADOW, NY

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General NPI Number Information
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    NPI Number           |    1528193596
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    Entity Type          |    Individual 
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    Provider Name        |    JINYEON KIM
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/22/2007
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    Last Update Date     |    09/17/2025
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Provider Practice Location Address
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    Address Line         |    485 BELLMORE AVE 
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    City                 |    EAST MEADOW
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    State                |    NY
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    Zip                  |    11554-4706
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    Country              |    US
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    Telephone            |    516-557-4772
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2525 DOGWOOD AVE 
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    City                 |    EAST MEADOW
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    State                |    NY
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    Zip                  |    11554-4216
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    Country              |    US
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    Telephone            |    516-221-1440
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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        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    002798
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    License Number State |    NY
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