Provider Demographics
NPI:1437279460
Name:KIM, YOUNG MEE (LAC)
Entity Type:Individual
Prefix:MS
First Name:YOUNG
Middle Name:MEE
Last Name:KIM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 WYNDROCK LN
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-2261
Mailing Address - Country:US
Mailing Address - Phone:716-689-0265
Mailing Address - Fax:
Practice Address - Street 1:2805 WEHRLE DR STE 13
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7383
Practice Address - Country:US
Practice Address - Phone:716-839-0265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001109171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist