Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 235733 | NY |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25MA08131400 | NJ |
N | 207VG0400X | Gynecologist | 235733 | NY |
N | 207VG0400X | Gynecologist | 25MA08131400 | NJ |
NPI | 1316000698 |
---|---|
Provider Name | Laura Sook Kim |
First Address | Flushing, NY 11355 |
Second Address | Flushing, NY 11355 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 03/07/2019 |