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Individual
SEOUNG SOU PARK
Active
Individual
SEOUNG SOU PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
197192
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01729675
—
NY
01
—
21N461
EMPIRE BCBS
NY
01
—
7464117
AETNA
—
01
—
P1229667
OXFORD HEALTH PLAN
—
Enumeration date
02/13/2007
Last updated
07/08/2007
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