SearchNew York207RR0500X

Brandon Kim

NPI 1992267173 · on the registry since 2019 · sole proprietor

Practice

Address
480 Forest Ave
Locust Valley, NY 11560
Phone
(631) 271-1640
Organisation at this address
The Medical Station Of North Shore Pc
The Medical Station Of Long Island Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
10

Registry record

Primary taxonomy
207RR0500X
207RR0500X
Also registered as
207R00000X
390200000X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-06-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York