Individual ProviderHakseong KimStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address622 W 168th St, New York, NY 10032(212) 305-6100PECOS EnrollmentBased on the most recent information from CMS, provider Hakseong Kim does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1609651876Provider TypeIndividualFull NameKim, HakseongTitleMr.GenderMaleSole ProprietorNoEnumeration Date8/28/2023Last Updated4/4/2024Contact InformationPractice LocationPractice Address622 W 168th St, New York, NY 10032Phone(212) 305-6100FaxUnlisted FaxMailing LocationMailing Address622 W 168th St, New York, NY 10032PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer