Individual provider · Type 1 NPI

Haksoo Kim, NURSE PRACTITIONER

Adult Health Nurse Practitioner · East Setauket, NY

NPI number 1013562891 Active

Practice location

26 Research Way
East Setauket, NY 11733-3526

Fax (631) 444-0187

Mailing address

101 Nicolls Rd, Hsc, Level 16, Rm 80
Stony Brook, NY 11794-8166

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200X309261 (NY)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1013562891

Haksoo Kim, NURSE PRACTITIONER's National Provider Identifier is 1013562891, issued on Aug 7, 2019. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in East Setauket, NY. The record was last updated on Jan 23, 2026.