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Individual

SUNJU PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3400 BAINBRIDGE AVE, BRONX, NY 10467
(718) 920-2020
Mailing address
3332 ROCHAMBEAU AVE FL 3, BRONX, NY 10467-2836
(718) 920-5520
(718) 881-5439

Taxonomy

Speciality
Code
Description
License number
State
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
292508
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
131740114
TAX ID
Enumeration date
03/18/2011
Last updated
06/20/2018
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