Provider Demographics
NPI:1447540554
Name:LIM, YOUNG SIK (CA)
Entity type:Individual
Prefix:
First Name:YOUNG SIK
Middle Name:
Last Name:LIM
Suffix:
Gender:M
Credentials:CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 ESSEX AVE
Mailing Address - Street 2:SUITE102
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2281
Mailing Address - Country:US
Mailing Address - Phone:732-548-2222
Mailing Address - Fax:732-548-2222
Practice Address - Street 1:173 ESSEX AVE
Practice Address - Street 2:SUITE102
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2281
Practice Address - Country:US
Practice Address - Phone:732-548-2222
Practice Address - Fax:732-548-2222
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-10
Last Update Date:2011-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00075200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist