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General NPI Number Information
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NPI Number | 1790901593
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Entity Type | Individual
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Provider Name | NANCY S KIM DDS
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Gender | Female
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | 115 E 61ST ST 14TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10065-8183
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Country | US
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Telephone | 212-838-7219
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Fax |
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Provider Business Mailing Address
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Address Line | 37 W 21ST ST #608
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City | NEW YORK
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State | NY
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Zip | 10010-8500
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Country | US
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Telephone | 212-838-7219
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 051284-1
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License Number State | NY
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