Provider Demographics
NPI:1265887988
Name:KYNG, KYMARA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:KYMARA
Middle Name:
Last Name:KYNG
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 1ST AVE
Mailing Address - Street 2:7N24
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9198
Mailing Address - Country:US
Mailing Address - Phone:212-263-6479
Mailing Address - Fax:212-263-8442
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:7N24
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9198
Practice Address - Country:US
Practice Address - Phone:212-263-6479
Practice Address - Fax:212-263-8442
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY523984-1163WP2201X
NYF339521-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care