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General NPI Number Information
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NPI Number | 1740545193
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Entity Type | Individual
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Provider Name | HYUN JEONG KIM
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Gender | Female
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 601 W 110TH STREET, #7J6
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City | NEW YORK
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State | NY
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Zip | 10025-2186
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Country | US
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Telephone | 347-725-7360
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Fax |
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Provider Business Mailing Address
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Address Line | 601 W 110TH ST # 7J6
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City | NEW YORK
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State | NY
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Zip | 10025-2186
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Country | US
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Telephone | 347-725-7360
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 641495121
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 641494121
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License Number State | NY
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