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Individual
SE JOONG PARK
Active
Individual
SE JOONG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
27912
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03865125
—
NY
Enumeration date
11/12/2009
Last updated
08/18/2020
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