Provider Demographics
NPI:1487982625
Name:LIM, TAK YEIN (MD)
Entity type:Individual
Prefix:DR
First Name:TAK YEIN
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 MOTT ST STE 501
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5575
Mailing Address - Country:US
Mailing Address - Phone:212-587-8838
Mailing Address - Fax:212-587-0050
Practice Address - Street 1:128 MOTT ST STE 501
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5575
Practice Address - Country:US
Practice Address - Phone:212-587-8838
Practice Address - Fax:212-587-0050
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-30
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003405-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY003405-1Other003405