Jenna Kim

Physician Assistant · Patchogue, NY

Individual Active NPI

NPI number 1730990417

Practice location

101 Hospital Rd
Patchogue, NY 11772-4870
Phone
(631) 654-7100

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NPI record

NPI
1730990417
Entity type
Individual (Type 1)
Enumeration date
January 14, 2025
Last updated
March 12, 2025
Certified
March 12, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X — —

Mailing address

2037 Dauntless Dr
Glenview, IL 60026-6811

About Jenna Kim

Jenna Kim is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 101 Hospital Rd, Patchogue, NY 11772-4870. The NPI number 1730990417 was assigned on January 14, 2025 and the record was last updated on March 12, 2025.

Frequently asked questions

What is the NPI number of Jenna Kim?

The NPI number is 1730990417.

What is the phone number of Jenna Kim?

The phone number listed for the practice location is (631) 654-7100.

Where is Jenna Kim located?

101 Hospital Rd, Patchogue, NY 11772-4870.

What is the taxonomy code for Jenna Kim?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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