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General NPI Number Information
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NPI Number | 1689114076
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Entity Type | Individual
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Provider Name | EMMA KIM OTR/L, CLT
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Gender | Female
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Dates
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Enumeration Date | 03/03/2017
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 119 W 57TH ST STE 212
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City | NEW YORK
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State | NY
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Zip | 10019-2302
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Country | US
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Telephone | 212-421-5505
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Fax |
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Provider Business Mailing Address
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Address Line | 4326 165TH ST APT 3H
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City | FLUSHING
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State | NY
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Zip | 11358-3257
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Country | US
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Telephone | 914-434-3006
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 020985
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License Number State | NY
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