Provider Demographics
NPI:1013301951
Name:KIM, ANNA (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 LEXINGTON AVE FL 12
Mailing Address - Street 2:NORTHWELL BEHAVIORAL HEALTH
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6828
Mailing Address - Country:US
Mailing Address - Phone:646-665-6020
Mailing Address - Fax:646-665-6949
Practice Address - Street 1:560 LEXINGTON AVENUE, 12TH FL
Practice Address - Street 2:NORTHWELL BEHAVIORAL HEALTH
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10022-6828
Practice Address - Country:US
Practice Address - Phone:646-665-6020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2852242084P0015X, 2084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine