MARY KIRSTYLEIGH ANN REVILLA LIM M.D NPI 1376168344

NPI Information

Mary Kirstyleigh Ann Revilla Lim, M.D is a student in an organized health care education training program in New York, NY. 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. Mary Kirstyleigh Ann Revilla Lim, M.D NPI is 1376168344. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

506 LENOX AVENUE
DEPARTMENT OF PEDIATRICS, MARTIN LUTHER KING BUILDING,
NEW YORK, NY
ZIP 10037
Phone: (212) 939-4019
Fax: (212) 939-4022

The enumeration date for this NPI number is 6/15/2020 and was last updated on 5/12/2021.

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:

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