Individual provider · Type 1 NPI

Jenna Bora Kim

Physician Assistant · Patchogue, NY

NPI number 1730990417 Active

Practice location

101 Hospital Rd
Patchogue, NY 11772-4870

Call (631) 654-7100 Map

Mailing address

11951 Modena Ln
Orlando, FL 32827-7161

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1730990417

Jenna Bora Kim's National Provider Identifier is 1730990417, issued on Jan 14, 2025. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Patchogue, NY. The record was last updated on Oct 27, 2026.