Provider Demographics
NPI:1740938547
Name:DR. HYOUNG GYO KIM L.AC P.C.
Entity type:Organization
Organization Name:DR. HYOUNG GYO KIM L.AC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HYOUNG GYO
Authorized Official - Middle Name:GYO
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:917-968-3335
Mailing Address - Street 1:PO BOX 1133
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-0133
Mailing Address - Country:US
Mailing Address - Phone:917-968-3335
Mailing Address - Fax:
Practice Address - Street 1:34 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-2034
Practice Address - Country:US
Practice Address - Phone:917-968-3335
Practice Address - Fax:800-293-8680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty