Provider Demographics
NPI:1932257086
Name:KIM, WOON-OK (NP)
Entity Type:Individual
Prefix:
First Name:WOON-OK
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:NP
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5457 WAYNE AVE
Mailing Address - Street 2:NEW COURTLAND LIFE AND ADULT DAY PROGRAM
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-3433
Mailing Address - Country:US
Mailing Address - Phone:267-335-1500
Mailing Address - Fax:267-286-8250
Practice Address - Street 1:5457 WAYNE AVE
Practice Address - Street 2:NEW COURTLAND LIFE AND ADULT DAY PROGRAM
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-3433
Practice Address - Country:US
Practice Address - Phone:263-335-1500
Practice Address - Fax:267-286-8250
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP008773363LG0600X
NJ26NJ00164900363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology