Provider Demographics
NPI:1174760243
Name:KIM, HELEN (DPT)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 W 72ND ST RM 606
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3262
Mailing Address - Country:US
Mailing Address - Phone:646-643-4688
Mailing Address - Fax:866-264-4230
Practice Address - Street 1:155 W 72ND ST RM 606
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3262
Practice Address - Country:US
Practice Address - Phone:646-643-4688
Practice Address - Fax:866-264-4230
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030912208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400068688Medicare PIN