Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Functional Nurse Practitioner in Family Health

Organization Clinic/Center · NPI 1619862943

Functional Nurse Practitioner in Family Health is a Clinic/Center in New York, New York. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2

Practice location Address checks out

2 W 32nd St Ste 602
New York, NY 10001-0602
Phone: (917) 309-0729
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1619862943
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Hyunchu Kim Gold — Staff Nurse Practitioner · (917) 309-0729
Other names Revive Wellness; Revive Wellness
NPI enumeratedJune 9, 2025
Last updated in NPPESJune 25, 2025
Certification dateJune 25, 2025
Mailing address2 W 32nd St Ste 602, New York, NY 10001-0602

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