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Individual
DR. TINA PARK
Active
Individual
DR. TINA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LP01591
RI
207RG0100X
Gastroenterology Physician
Primary
277511
NY
Other
Enumeration date
06/25/2009
Last updated
04/29/2019
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