Provider Demographics
NPI:1881919868
Name:KIM, LUCY KYUNGHWA (PHARMD)
Entity type:Individual
Prefix:MS
First Name:LUCY
Middle Name:KYUNGHWA
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9138 50TH AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4000
Mailing Address - Country:US
Mailing Address - Phone:718-699-3339
Mailing Address - Fax:
Practice Address - Street 1:9138 50TH AVE FL 1
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4000
Practice Address - Country:US
Practice Address - Phone:718-699-3339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054020183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist