Provider Demographics
NPI:1386950020
Name:KIM, YOONYOUNG (PHARM,D)
Entity type:Individual
Prefix:
First Name:YOONYOUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARM,D
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:584 ANDERSON AVE
Mailing Address - Street 2:4B
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-1727
Mailing Address - Country:US
Mailing Address - Phone:201-943-4349
Mailing Address - Fax:
Practice Address - Street 1:1320 SHIPYARD LN
Practice Address - Street 2:#3-#4
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5582
Practice Address - Country:US
Practice Address - Phone:201-876-0040
Practice Address - Fax:201-876-4125
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03143700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist