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1992267173 NPI number — BRANDON HOONGYUNG KIM

NPI Number: 1992267173
Health Care Provider/Practitioner: BRANDON HOONGYUNG KIM

Information about “1992267173” NPI (BRANDON HOONGYUNG KIM) exists in 1992267173 in HTML format HTML  |  1992267173 in plain Text format TXT  |  1992267173 in PDF (Portable Document Format) PDF  |  1992267173 in an XML format XML  formats.

NPI Number : 1992267173 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1992267173",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KIM",
    "FirstName": "BRANDON",
    "MiddleName": "HOONGYUNG",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "480 FOREST AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOCUST VALLEY",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11560-2151",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "631-271-1640",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "480 FOREST AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOCUST VALLEY",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11560-2151",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "631-271-1640",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/05/2019",
    "LastUpdateDate": "06/28/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "331687",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RR0500X",
          "TaxonomyName": "Rheumatology Physician",
          "LicenseNumber": "331687",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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