Provider Demographics
NPI:1750834289
Name:RIM, HO RHEEM (LAC)
Entity Type:Individual
Prefix:
First Name:HO RHEEM
Middle Name:
Last Name:RIM
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16213 46TH AVE STE 2B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3699
Mailing Address - Country:US
Mailing Address - Phone:917-336-2880
Mailing Address - Fax:
Practice Address - Street 1:16213 46TH AVE UNIT 2B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3616
Practice Address - Country:US
Practice Address - Phone:917-336-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4026171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist