Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 117583 | NY |
NPI | 1912003229 |
---|---|
Provider Name | Myung Hyo Kim |
First Address | Loudonville, NY 12211-1308 |
Second Address | Latham, NY 12110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 30/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00430644 | (05) | NY |
D78471 | (02) |