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Organization

SAMUEL PARK MD, PLLC

Active
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Organization

SAMUEL PARK MD, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL J PARK MD (PRESIDENT)
(516) 619-8098
Entity
Organization

Contact information

Practice address
160 1ST ST UNIT 551, MINEOLA, NY 11501-5025
(516) 619-8098
Mailing address
160 1ST ST UNIT 551, MINEOLA, NY 11501-5025
(516) 619-8098

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
208000000X
Pediatrics Physician

Other

Enumeration date
09/26/2016
Last updated
06/06/2019
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