| Organization Name: | WOO SUP KIM M D P C |
| NPI Number: | 1104198878 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WOO SUP KIM (D.R) |
| Mailing Address: | 9711 101st Ave Ozone Park |
| State: | NY US |
| Postal Code: | 114162523 |
| Phone Number: | 7188456000 |
| Fax Number: | |
| NPI Enumeration Date: | 01/27/2012 |
| NPI Last Update Date: | 03/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 160493 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |