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

Misook Kim

Individual provider Physician Assistant · NPI 1205905056

Misook Kim is a Physician Assistant in Port Jefferson, New York. Licensed in New York. Registered with an NPI since 2006.

Licensed in
NY
In the registry since
2006

Practice location Address checks out

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone: (631) 473-1320
Fax: (631) 686-7653
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 009693 (NY)

Record details

NPI number1205905056
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 7, 2006
Last updated in NPPESOctober 22, 2015

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