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General NPI Number Information
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NPI Number | 1578457925
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Entity Type | Individual
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Provider Name | EUN KYUNG KIM
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Gender |
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 19411 NORTHERN BLVD
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City | FLUSHING
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State | NY
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Zip | 11358-3032
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Country | US
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Telephone | 929-539-9443
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Fax |
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Provider Business Mailing Address
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Address Line | 6254 97TH PL
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City | REGO PARK
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State | NY
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Zip | 11374-1346
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Country | US
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Telephone | 917-608-7144
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F310597
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License Number State | NY
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