Provider Demographics
NPI:1770918054
Name:KIM, HYEON-KYEONG (MSED)
Entity type:Individual
Prefix:MRS
First Name:HYEON-KYEONG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 TENAKILL PARK E
Mailing Address - Street 2:
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-2023
Mailing Address - Country:US
Mailing Address - Phone:201-674-8351
Mailing Address - Fax:
Practice Address - Street 1:2103 TENAKILL PARK E
Practice Address - Street 2:
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626-2023
Practice Address - Country:US
Practice Address - Phone:201-674-8351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1076927174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist