Provider Demographics
NPI:1477267995
Name:KIM, YOU JIN HARRIS (LAC, DACM)
Entity Type:Individual
Prefix:DR
First Name:YOU JIN
Middle Name:HARRIS
Last Name:KIM
Suffix:
Gender:M
Credentials:LAC, DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W 21ST ST RM 904
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6851
Mailing Address - Country:US
Mailing Address - Phone:347-201-3628
Mailing Address - Fax:
Practice Address - Street 1:19 W 21ST ST RM 904
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6851
Practice Address - Country:US
Practice Address - Phone:347-201-3628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007234171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist