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General NPI Number Information
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NPI Number | 1891475349
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Entity Type | Individual
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Provider Name | YEONG C KIM
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Gender | Male
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 98 MEADOWVIEW CT
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City | LEONIA
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State | NJ
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Zip | 07605-2041
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Country | US
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Telephone | 201-655-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 98 MEADOWVIEW CT
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City | LEONIA
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State | NJ
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Zip | 07605-2041
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Country | US
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Telephone | 201-655-4500
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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 | 25MZ00166400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 007310
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 18KT01455700
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 033138
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License Number State | NY
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