National Provider Identifier

Hyonju Kim, MD

Hyonju Kim, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Ithaca, NY and a listed phone number of (607) 339-0494.

NPI 1578143475Ithaca, NYStudent in an Organized Health Care Education/Training Program

Profile Overview

NPI
1578143475
Provider Type
Individual
Primary Specialty
Student in an Organized Health Care Education/Training Program
Enumeration Date
April 13, 2021
Last Updated
April 13, 2021

Practice Location

  • 101 Dates Dr
  • Ithaca, NY 14850-1383

Phone: (607) 339-0494

Specialties

  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1578143475
Entity Type
Individual
Last Name
Kim
First Name
Hyonju
Credential
MD
Mailing Street Address
101 Dates Dr
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-1383
Mailing Country
US
Practice Street Address
101 Dates Dr
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-1383
Practice Country
US
Practice Phone
(607) 339-0494
Enumeration Date
April 13, 2021
Last Updated
April 13, 2021
Sex
Female
Sole Proprietor
No
Certification Date
April 13, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Student in an Organized Health Care Education/Training Program (390200000X)