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General NPI Number Information
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NPI Number | 1740647213
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Entity Type | Individual
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Provider Name | JENNY KIM FNP
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Gender | Female
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 41 E POST RD
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City | WHITE PLAINS
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State | NY
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Zip | 10601-4607
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Country | US
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Telephone | 914-681-2580
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Fax |
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Provider Business Mailing Address
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Address Line | 421 WHITE PLAINS RD APT 1
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City | EASTCHESTER
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State | NY
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Zip | 10709-2809
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 340153
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License Number State | NY
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