Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 250443 | NY |
NPI | 1336305390 |
---|---|
Provider Name | Bora V Kim |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Bayside, NY 11360-5908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2008 |
Last Update Date | 14/01/2020 |