Individual provider · Type 1 NPI

Ellen Kim

Student in an Organized Health Care Education/Training Program · Boston, MA

NPI number 1063354850 Active

Practice location

800 Washington St
Boston, MA 02111-1552

Call (617) 636-5000 Map

Mailing address

6550 Gladeview Ct
Burke, VA 22015-4113

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: 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.

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About NPI 1063354850

Ellen Kim's National Provider Identifier is 1063354850, issued on Apr 8, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Boston, MA. The record was last updated on Apr 8, 2026.