MEDICARE: MS. YOUNG MEE KIM L.A.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	001109	NY

General Provider Information

NPI Number	:	1437279460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. YOUNG MEE KIM L.A.C

Provider Business Mailing Address
First Line	:	39 WYNDROCK LN
Second Line	:
City	:	EAST AMHERST
State	:	NY
Zip	:	14051-2261
Country	:	US
Telephone Number	:	716-689-0265
Fax Number	:

Provider Business Practice Location Address
First Line	:	2805 WEHRLE DR STE 13
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-7383
Country	:	US
Telephone Number	:	716-839-0265
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2007
Last Update Date	:	07/08/2007

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