Kim, Jung-Yong

Kim, Jung-Yong is an individual health care provider with primary practice located at 285 Sills Rd Bldg 16, East Patchogue NY 11772-4808. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Kim, Jung-Yong can be contacted via phone (631) 758-7575.

Contact Information

Primary practice address
285 Sills Rd Bldg 16 East Patchogue NY 11772-4808
Phone: (631) 758-7575
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 144403 New York

Profile Details

NPI number 1013911478
LBN Legal business name Kim, Jung-Yong
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Dec 19th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013911478 NPPES
New York MEDICAID 00786374

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