Minerva Kim, RD | |
101 Northern Blvd, Greenvale, NY 11548-1340 | |
(516) 563-7940 | |
Not Available |
Full Name | Minerva Kim |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 101 Northern Blvd, Greenvale, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1740941467 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133V00000X | Dietitian, Registered | (New York) | Primary |
Provider Name | Chs Physician Partners Pc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1164585725 PECOS PAC ID: 7618955667 Enrollment ID: O20040708000027 |
Mailing Address | Practice Location Address |
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Minerva Kim, RD 101 Northern Blvd, Greenvale, NY 11548-1340 Ph: () - | Minerva Kim, RD 101 Northern Blvd, Greenvale, NY 11548-1340 Ph: (516) 563-7940 |
Stephen Wickes, RD, CDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 340 Wheatley Plz Ste B, Greenvale, NY 11548 Phone: 516-351-2350 | |
Davina Kahen, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 23 Locust St, Greenvale, NY 11548 Phone: 516-209-8603 | |
Tara Walsh, RD Dietitian Medicare: Medicare Enrolled Practice Location: 101 Northern Blvd, Greenvale, NY 11548 Phone: 516-563-7947 |