Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 221460 | NY |
NPI | 1093890972 |
---|---|
Provider Name | Dr. Paul Joon Kim |
First Address | Elmhurst, NY 11373-1329 |
Second Address | Jamaica, NY 11432-1121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00246075 | (05) | NY |
I33210 | (02) | NY |