Myung Kim, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

95318198 Issued in CA

Practice address

623 N Wood Ave # 6B
Linden, NJ 07036-4151

Phone

(908) 486-0990

NPI assigned

Oct 30, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1053133017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 W VALENCIA MESA DR",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354010",
            "telephone_number": "917-865-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 N WOOD AVE # 6B",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070364151",
            "telephone_number": "908-486-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MYUNG",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95318198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Temi Kelman
• Sara Khalil
• Madeeha Sabahat Khan, OD
• Punkaj Khanna, PHARM D
• Jung Tae Kim, P.T.
• John A Kline, MD
• Gabriela Kostikova
• Michael J. Kotch, M.D.
• Natalie Koziupa, APN
• Jenni Kwiatkowski, DDS

• Gerontology Nurse Practitioner in Linden, NJ
• Providers in Linden, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.