MEDICARE: HELEN KIM

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	183500000X	Pharmacist	059805	NY

General Provider Information

NPI Number	:	1720465040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN KIM

Provider Business Mailing Address
First Line	:	25121 JAMAICA
Second Line	:
City	:	BELLEROSE
State	:	NY
Zip	:	11426-2218
Country	:	US
Telephone Number	:	516-488-3998
Fax Number	:

Provider Business Practice Location Address
First Line	:	25121 JAMAICA
Second Line	:
City	:	BELLEROSE
State	:	NY
Zip	:	11426-2218
Country	:	US
Telephone Number	:	516-488-3998
Fax Number	:

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

Provider Enumeration Date	:	05/06/2015
Last Update Date	:	05/06/2015

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Directions to “ HELEN KIM ” Practice Location

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