JIYON JENNIFER KIM (NPI# 1942388061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942388061 |
| Entity Type | Individual |
| Full Name | JIYON JENNIFER KIM |
| Credential | P.A.-C., MPAS |
| Practice Address |
727 Broadway Suite B4 Massapequa NY 11758 |
| Mailing Address |
755 Park Ave Ste 500 Huntington NY 11743-3979 |
| Practice Telephone | 5167990210 |
| Practice Fax Number | 5167996569 |
| Mailing Telephone | 6312712769 |
| Mailing Fax Number | 6312711730 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2019-05-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
006956 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104101591 | Jiyon Kim | Psychologist | 1991 Marcus Ave, Suite 104, New Hyde Park, NY 11042-2057 | 2011-10-17 |
| 1124104856 | Jiyon Kim | Dentist | 344 Morris Ave S, Renton, WA 98057-2521 | 2006-10-27 |
| Street Address |
727 BROADWAY SUITE B4 |
| City | MASSAPEQUA |
| State | NY |
| Zip Code | 11758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518245810 | Linda M Wright-senzer | Counselor | 727 Broadway, Ste B3, Massapequa, NY 11758-2345 | 2011-08-03 |
| 1609945617 | Marietta Busa | Physician Assistant | 727 Broadway, Massapequa, NY 11758 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811535339 | Jamie Leigh Disilvio | Licensed Practical Nurse | 24 Amity Pl., Massapequa, NY 11758 | 2019-12-16 |
| 1548787955 | June H Friedman | Social Worker | 78 North Pine Street, North Massapequa, NY 11758 | 2017-08-25 |
| 1376078568 | Caitlin Bree Kennedy | Acupuncturist | 507 Hicksville Road, Massapequa, NY 11758 | 2017-04-25 |
| 1932645561 | Maria Amato | Specialist | 277 Division Ave, Massapequa, NY 11758 | 2017-01-06 |
| 1164877270 | Marylou Lawson | Early Intervention Provider Agency | 87 N Pine Street, N Massapequa, NY 11758 | 2016-04-26 |
| 1417314196 | Tender Heart Senior Care Corp | In Home Supportive Care | 24 Peconic Dr, Massapequa, NY 11758 | 2016-01-26 |
| 1316328420 | Theresa Mackey | Behavioral Analyst | 19 Oxford Avenue, N. Massapequa, NY 11758 | 2015-06-15 |
| 1932596590 | Bianca Ferrantelli | Specialist | 13 Alhabra Rd, Apt 5, Massapequa, NY 11758 | 2015-04-22 |
| 1245625797 | Medwell Medical PC | Pain Medicine | 1065a North Broadway, Massapequa, NY 11758 | 2015-04-01 |
| 1053703926 | Joseph Sgaglione | Physical Therapist | 503 Wright Drive, Massapequa, NY 11758 | 2015-03-02 |
| Find all providers in zip 11758 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033491303 | Lawrence Waxman | Physician Assistant | 5500 Merrick Rd, Massapequa, NY 11758-6231 | 2011-09-13 |
| 1285823567 | Geoffrey B Pollock | Physician Assistant | 660 Broadway, Massapequa, NY 11758-2391 | 2007-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434727 | Julia Loren Bartsch | Physician Assistant | 11791 Genesee St, Alden, NY 14004-9713 | 2020-10-16 |
| 1295347078 | Alana Janine Miller | Physician Assistant | 1060 5th Ave # 1b, New York, NY 10128-0104 | 2020-08-21 |
| 1336768647 | Abul Sarker | Physician Assistant | 2 Sagamore Ave, Suffern, NY 10901-7412 | 2020-04-16 |
| 1689200412 | Margaret Ann Sullivan | Physician Assistant | 7011 108th St Apt 4l, Forest Hills, NY 11375-4407 | 2020-03-12 |
| 1376177527 | Anabell Marina Lopez Plaza | Physician Assistant | 12 Berrywood Ct, Bay Shore, NY 11706-2058 | 2020-02-26 |
| 1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
| 1831736602 | Ll Physician Assistant PC | Physician Assistant | 2279 Coney Island Ave Fl 2, Brooklyn, NY 11223-3337 | 2019-11-29 |
| 1992348775 | Nafiur Rahman Chowdhury | Physician Assistant | 8268 164th St Rm A3-65, Jamaica, NY 11432-1121 | 2019-10-23 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1578114377 | Matthew Newmark Eisenstein | Physician Assistant | 3260 43rd St Apt 2r, Astoria, NY 11103-2745 | 2019-09-23 |
| Find all providers with the same taxonomy | ||||
| City | MASSAPEQUA |
| Zip Code | 11758 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.