Provider Demographics
NPI:1386253946
Name:KIM, CLAIRE (LMT)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 PARSONS BLVD APT 2B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4606
Mailing Address - Country:US
Mailing Address - Phone:631-552-0903
Mailing Address - Fax:
Practice Address - Street 1:3420 PARSONS BLVD APT 2B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4606
Practice Address - Country:US
Practice Address - Phone:631-552-0903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030314225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist