Doctor Name: | JUNG-YONG KIM |
NPI Number: | 1013911478 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 144403 |
Business Practice Address: | 285 Sills Rd Bldg 16 East Patchogue, NY - 117724808 |
Business Phone Number: | 6317587575 |
Business Fax Number: | |
Mailing Address: | 235 N Belle Mead Rd, E SETAUKET |
State: | NY |
Postal Code: | 117333456 |
Phone Number: | 6317513000 |
Fax Number: | 6317513366 |
NPI Enumeration Date: | 06/13/2005 |
NPI Last Update Date: | 12/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 144403 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |