Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 218819 | NY |
NPI | 1023095171 |
---|---|
Provider Name | Dr. Bette Kim |
First Address | New York, NY 10017-5699 |
Second Address | New York, NY 10019-1104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 24/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02682635 | (05) | NY |
I44170 | (02) | NY |