Provider Demographics
NPI:1811525355
Name:KIM, YESUL TINA (MD)
Entity type:Individual
Prefix:DR
First Name:YESUL
Middle Name:TINA
Last Name:KIM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:920 48TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2918
Mailing Address - Country:US
Mailing Address - Phone:718-283-7800
Mailing Address - Fax:718-635-7147
Practice Address - Street 1:920 48TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2918
Practice Address - Country:US
Practice Address - Phone:718-283-7800
Practice Address - Fax:718-635-7147
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3138192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry