Provider Demographics
NPI:1386350130
Name:KATHERINE KIM, M.D., P.C.
Entity type:Organization
Organization Name:KATHERINE KIM, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-540-5916
Mailing Address - Street 1:928 BROADWAY STE 1100
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-8115
Mailing Address - Country:US
Mailing Address - Phone:917-540-5916
Mailing Address - Fax:
Practice Address - Street 1:928 BROADWAY STE 1100
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8115
Practice Address - Country:US
Practice Address - Phone:917-540-5916
Practice Address - Fax:917-900-1912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health