Basic Information
| Provider Information | |||||||||
| NPI: | 1912211384 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIM | ||||||||
| FirstName: | CHRISTY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 PLAZA W | ||||||||
| Address2: | MUNGER PAVILION, ROOM 106 | ||||||||
| City: | VALHALLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105951574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144937585 | ||||||||
| FaxNumber: | 9145944336 | ||||||||
| Practice Location | |||||||||
| Address1: | 19 BRADHURST AVE | ||||||||
| Address2: | SUITE 1400 | ||||||||
| City: | HAWTHORNE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105322140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144937585 | ||||||||
| FaxNumber: | 9145944336 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2010 | ||||||||
| LastUpdateDate: | 04/17/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0214X | 254404 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology |
No ID Information.