Provider Demographics
NPI:1346427747
Name:KIM, HOJUNG (RPH)
Entity Type:Individual
Prefix:MS
First Name:HOJUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21967 67TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2638
Mailing Address - Country:US
Mailing Address - Phone:718-225-5167
Mailing Address - Fax:
Practice Address - Street 1:21967 67TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-2638
Practice Address - Country:US
Practice Address - Phone:718-225-5167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist