Provider Demographics
NPI:1851619068
Name:KIM, LINDA WEA (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:WEA
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:37-30 73RD STREET
Mailing Address - Street 2:PQ
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6249
Mailing Address - Country:US
Mailing Address - Phone:718-803-9888
Mailing Address - Fax:718-803-9833
Practice Address - Street 1:37-30 73RD STREET
Practice Address - Street 2:PQ
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6249
Practice Address - Country:US
Practice Address - Phone:718-803-9888
Practice Address - Fax:718-803-9833
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY128328207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology