Provider Demographics
NPI:1225531924
Name:KIM, YUJI (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:YUJI
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W 60TH ST APT 1N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7906
Mailing Address - Country:US
Mailing Address - Phone:917-601-8647
Mailing Address - Fax:
Practice Address - Street 1:30 W 60TH ST APT 1N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7906
Practice Address - Country:US
Practice Address - Phone:917-601-8647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-09
Last Update Date:2025-11-12
Deactivation Date:2023-08-30
Deactivation Code:
Reactivation Date:2025-08-21
Provider Licenses
StateLicense IDTaxonomies
NY312618363LA2200X
NY6174171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturist
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty