Provider Demographics
NPI:1962699371
Name:JOHN KIM ACUPUNTURE P.C.
Entity type:Organization
Organization Name:JOHN KIM ACUPUNTURE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KWANG
Authorized Official - Middle Name:YEAL
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:718-321-2511
Mailing Address - Street 1:3731 149TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4841
Mailing Address - Country:US
Mailing Address - Phone:718-321-2511
Mailing Address - Fax:718-321-7525
Practice Address - Street 1:3731 149TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4841
Practice Address - Country:US
Practice Address - Phone:718-321-2511
Practice Address - Fax:718-321-7525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-29
Last Update Date:2007-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028926171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty