Provider Demographics
NPI:1477349330
Name:YIM, CHAESEONG (MD)
Entity type:Individual
Prefix:MR
First Name:CHAESEONG
Middle Name:
Last Name:YIM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 GEUMOSAN-RO 6-GIL
Mailing Address - Street 2:
Mailing Address - City:GUM-SI
Mailing Address - State:GYEONGSANGBUK-DO
Mailing Address - Zip Code:39223
Mailing Address - Country:KR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1901 1ST AVENUE
Practice Address - Street 2:MAIN BUILDING, ROOM 704
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-423-6771
Practice Address - Fax:212-423-8099
Is Sole Proprietor?:No
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program