Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 199594 | NY |
NPI | 1063420958 |
---|---|
Provider Name | Helen Hyosun Kim |
First Address | Staten Island, NY 10301 |
Second Address | Staten Island, NY 10301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 02/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01765379 | (05) | NY |
G55124 | (02) |