NPIMap

Organization Active NPI

My Health Medical Wellness PC

  • General Practice Physician
  • Flushing, NY
National Provider Identifier
1295008779
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
236715 Issued in NY
Legal business name
MY HEALTH MEDICAL WELLNESS PC
Practice address
142-25 37TH Ave. #C3
Flushing, NY 11354-6508
Phone
(718) 359-3777
Fax
(718) 359-3770
NPI assigned
Feb 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Authorized official

Name
Dr. Yong Jun Kim, M.D.
Title
President
Phone
(718) 359-3777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 236715 NY Primary

Addresses

Primary practice location

142-25 37TH Ave. #C3
Flushing, NY 11354-6508

Mailing address

142-25 37TH Ave. #C3
Flushing, NY 11354-6508
Phone (718) 359-3777

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1295008779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142-25 37TH AVE. #C3",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546508",
            "telephone_number": "718-359-3777",
            "fax_number": "718-359-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142-25 37TH AVE. #C3",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546508",
            "telephone_number": "718-359-3777",
            "fax_number": "718-359-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY HEALTH MEDICAL WELLNESS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YONG JUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-359-3777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NY",
            "license": "236715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.