DR. KYLE HYUNGU KIM (NPI# 1952863268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952863268 |
| Entity Type | Individual |
| Full Name | DR. KYLE HYUNGU KIM |
| Credential | MD |
| Practice Address |
301 E Main St Bay Shore NY 11706-8458 |
| Practice Telephone | 6319683970 |
| Mailing Telephone | 6319683970 |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2019-04-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
301 E MAIN ST |
| City | BAY SHORE |
| State | NY |
| Zip Code | 11706-8458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053959 | Ebne Rafi | Pharmacist | 301 E Main St, Bay Shore, NY 11706-8408 | 2020-11-03 |
| 1154928711 | Brittany Lee Mulligan | Anesthesiology | 301 E Main St, Bay Shore, NY 11706-8408 | 2020-10-07 |
| 1093322786 | Aliesha Wahab | Pharmacist | 301 E Main St, Bay Shore, NY 11706-8458 | 2020-09-26 |
| 1316553795 | Erica Anne Schott | Pharmacist | 301 E Main St, Bay Shore, NY 11706-8408 | 2020-09-21 |
| 1780296913 | Chelsea Jensen | Physician Assistant | 301 E Main St, Bay Shore, NY 11706-8408 | 2020-08-19 |
| 1669081865 | John William Mcdonnell Jr. | Physician Assistant | 301 E Main St, Bay Shore, NY 11706-8408 | 2020-07-24 |
| 1205445566 | Michele Lisa Guelfi | Local Education Agency (LEA) | 301 E Main St, Bay Shore, NY 11706-8458 | 2020-07-23 |
| 1740899921 | Colleen Stubbs | Nurse Practitioner | 301 E Main St, Bay Shore, NY 11706-8458 | 2020-07-23 |
| 1063030757 | Rigoberto Ventura | Physician Assistant | 301 E Main St, Bay Shore, NY 11706-8408 | 2020-07-08 |
| 1780200709 | Valerie Brooke Matedero | Physician Assistant | 301 E Main St, Bay Shore, NY 11706-8408 | 2020-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598394173 | Erin Marie Barlow | Student in an Organized Health Care Education/Training Program | Southside Emergency Department 301 East Main Street, Bay Shore, NY 11706 | 2020-04-06 |
| 1003460890 | Bay Shore Brightwaters Rescue Ambulance Inc. | Ambulance | 911 Aletta Place, Bay Shore, NY 11706 | 2019-07-30 |
| 1861980872 | Raffy Gutman | Student in an Organized Health Care Education/Training Program | Southside Hospital Family Medicine, 301 E Main St, Bay Shore, NY 11706 | 2018-04-25 |
| 1609371004 | Sengal Kelit Alazar | Student in an Organized Health Care Education/Training Program | South Side Hospital Emergency Department - Northwell, 301 East Main Street, Bay Shore, NY 11706 | 2018-03-27 |
| 1780198671 | Stefany Gabriela Armijos | Social Worker | 144 Fifth Ave, Bay Shore, NY 11706 | 2017-11-30 |
| 1417476771 | Jazmin Unda Jimenez | Licensed Practical Nurse | 236 Adams Ave, Bay Shore, NY 11706 | 2017-09-18 |
| 1013436989 | People Pushers LLC | Non-emergency Medical Transport (VAN) | 50 Corbin Ave, Suite D, Bay Shore, NY 11706 | 2017-09-12 |
| 1871011585 | Life Acupuncture & Massage Therapy P.C. | Acupuncturist | 387 East Main Street Suite 104, Bayshore, NY 11706 | 2017-09-01 |
| 1558881458 | Wilda Novembre | Licensed Practical Nurse | 1742 North Thompson Drive, Bayshore, NY 11706 | 2017-06-21 |
| 1194184085 | Georgette Prawl | Nurse's Aide | 54 1st Avenue, Bayshore, NY 11706 | 2016-02-19 |
| Find all providers in zip 11706 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598394173 | Erin Marie Barlow | Student in an Organized Health Care Education/Training Program | Southside Emergency Department 301 East Main Street, Bay Shore, NY 11706 | 2020-04-06 |
| 1902447915 | Nicholas Kelly | Student in an Organized Health Care Education/Training Program | 1089 Manor Ln, Bay Shore, NY 11706-6224 | 2019-10-01 |
| 1861980872 | Raffy Gutman | Student in an Organized Health Care Education/Training Program | Southside Hospital Family Medicine, 301 E Main St, Bay Shore, NY 11706 | 2018-04-25 |
| 1609371004 | Sengal Kelit Alazar | Student in an Organized Health Care Education/Training Program | South Side Hospital Emergency Department - Northwell, 301 East Main Street, Bay Shore, NY 11706 | 2018-03-27 |
| 1053832949 | Harneet Bedi | Student in an Organized Health Care Education/Training Program | 28 Penataquit Ave, Bay Shore, NY 11706-8009 | 2017-06-29 |
| 1720509623 | Gurpal Singh Dhanjal | Student in an Organized Health Care Education/Training Program | 2061 Union Blvd Apt 1d, Bay Shore, NY 11706-8036 | 2017-06-29 |
| 1346794252 | Rochelle Smith | Student in an Organized Health Care Education/Training Program | 237 Vermont Ave, Bay Shore, NY 11706-2514 | 2016-08-09 |
| 1487016051 | Andy Moore | Student in an Organized Health Care Education/Training Program | 16 Tern Ct, Bay Shore, NY 11706-7529 | 2016-03-23 |
| 1891040572 | Tamas Ungar | Student in an Organized Health Care Education/Training Program | 29 Montgomery Ave, Bay Shore, NY 11706-8004 | 2012-07-18 |
| 1568743300 | Jeremy Lieber Kass | Student in an Organized Health Care Education/Training Program | 29 N Montgomery Ave, Bay Shore, NY 11706-8004 | 2011-09-07 |
| Find all providers in BAY SHORE | ||||
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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.