Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 290152 | NY |
NPI | 1093135931 |
---|---|
Provider Name | Dr. James Moo Kim |
First Address | New York, NY 10021-4745 |
Second Address | New York, NY 10065 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2014 |
Last Update Date | 22/02/2021 |