Individual provider Active NPI

Yunsam Kim

  • Acupuncturist
  • Fort Lee, NJ
National Provider Identifier
1477301034
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25MZ00170200 Issued in NJ
Practice address
1550 Lemoine Ave Ste 101
Fort Lee, NJ 07024-5608
Phone
(551) 239-1152
NPI assigned
May 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 25MZ00170200 NJ Primary

Addresses

Primary practice location

1550 Lemoine Ave Ste 101
Fort Lee, NJ 07024-5608

Mailing address

2413 6TH St Apt 2
Fort Lee, NJ 07024-7802
Phone (201) 655-9876

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

State licenses

LicenseStateTypeSpecialty
25MZ00170200NJMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1477301034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 6TH ST APT 2",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247802",
            "telephone_number": "201-655-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 LEMOINE AVE STE 101",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245608",
            "telephone_number": "551-239-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "YUNSAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NJ",
            "license": "25MZ00170200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.