Provider Type Icon

JIN S. IM M.D. NPI 1578842506


NPI Information

NPI: 1578842506
Provider Name: JIN S. IM, M.D.
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Organization: PHYSICIANS REFERRAL SERVICE

PECOS Registration: Yes

Address:
111 E 210TH ST
BRONX, NY
ZIP 10467
Phone: (718) 920-4321
Get Directions

Jin S. Im, M.D. is a student in an organized health care education training program in Bronx, NY with 15 years of experience. The provider is 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. Jin S. Im, M.D. NPI is 1578842506. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
Graduation Year:2009

The provider's business location address is:

111 E 210TH ST
BRONX, NY
ZIP 10467-401
Phone: (718) 920-4321

The NPI 1578842506 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/8/2011 and was last updated on 8/8/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training ProgramYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.