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General NPI Number Information
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NPI Number | 1972778280
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Entity Type | Organization
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Legal Business Name | KYNAM INC
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 08/02/2013
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Provider Practice Location Address
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Address Line | 8941 ELMHURST AVE
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City | ELMHURST
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State | NY
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Zip | 11373-1537
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Country | US
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Telephone | 718-205-0011
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Fax |
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Provider Business Mailing Address
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Address Line | 8941 ELMHURST AVE
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City | ELMHURST
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State | NY
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Zip | 11373-1537
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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 | OWNER
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Name | MS. EUN JUNG NAM
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Credential |
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Telephone | 347-677-2519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 028848
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License Number State | NY
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