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General NPI Number Information
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NPI Number | 1801532866
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Entity Type | Individual
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Provider Name | ALEX K KIM
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Gender | Male
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 60 DUTCH HILL RD STE 2B
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City | ORANGEBURG
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State | NY
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Zip | 10962-1722
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Country | US
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Telephone | 845-570-5057
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Fax |
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Provider Business Mailing Address
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Address Line | 1 SHORE LN APT 2210
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City | JERSEY CITY
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State | NJ
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Zip | 07310-2087
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Country | US
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Telephone | 551-486-1446
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 006920
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License Number State | NY
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