Provider Demographics
NPI:1992139539
Name:KIM, JULIET YOUNG (DACM, LAC)
Entity type:Individual
Prefix:DR
First Name:JULIET
Middle Name:YOUNG
Last Name:KIM
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5204
Mailing Address - Country:US
Mailing Address - Phone:718-866-7772
Mailing Address - Fax:
Practice Address - Street 1:110 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-3527
Practice Address - Country:US
Practice Address - Phone:516-399-0038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-30
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004380171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist