Active NPI
Harrison Dongsoo Kim
- Acupuncturist
- Palisades Park, NJ
National Provider Identifier
1124664719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 006575
- Practice address
- 17 Brinkerhoff Ter FL 2
Palisades Park, NJ 07650-1101 - Phone
- (315) 200-4860
- NPI assigned
- Nov 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 006575 | NY | Primary |
Addresses
Primary practice location
17 Brinkerhoff Ter FL 2
Palisades Park, NJ 07650-1101
Mailing address
1446 Westgate Dr.
Fort Lee, NJ 07024
Phone (315) 200-4860
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | wellnessmgt23@gmail.com | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742169600000",
"number": "1124664719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1446 WESTGATE DR.",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "07024",
"telephone_number": "315-200-4860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 BRINKERHOFF TER FL 2",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "076501101",
"telephone_number": "315-200-4860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HARRISON",
"middle_name": "DONGSOO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-19",
"last_updated": "2025-03-17",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "006575",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "wellnessmgt23@gmail.com",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "email",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "531 W 235th St",
"city": "Bronx",
"state": "NY",
"country_code": "US",
"postal_code": "104631795",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Palisades Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.