Provider Demographics
NPI:1831347962
Name:KIM, HYUNG S X (RPH)
Entity type:Individual
Prefix:MR
First Name:HYUNG
Middle Name:S
Last Name:KIM
Suffix:X
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 WILMOT RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6149
Mailing Address - Country:US
Mailing Address - Phone:914-723-8466
Mailing Address - Fax:914-723-8466
Practice Address - Street 1:124 WILMOT RD.
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-6149
Practice Address - Country:US
Practice Address - Phone:914-723-8466
Practice Address - Fax:914-723-8466
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030512-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY030512-1OtherPHARMACIST LINCENSE NUMBER