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General NPI Number Information
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NPI Number | 1871890327
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Entity Type | Individual
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Provider Name | MIHA KIM P.T.
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Gender | Female
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Dates
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Enumeration Date | 02/18/2011
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Last Update Date | 04/21/2014
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Provider Practice Location Address
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Address Line | 30 W 60TH ST SUITE 1C
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City | NEW YORK
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State | NY
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Zip | 10023-7902
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Country | US
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Telephone | 773-720-9876
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Fax |
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Provider Business Mailing Address
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Address Line | 546 W 147TH ST APT 4E
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City | NEW YORK
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State | NY
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Zip | 10031-4528
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Country | US
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Telephone | 773-720-9876
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 032646-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.012709
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0011080L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 25143
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License Number State | CA
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