Organization
COMPREHENSIVE FAMILY MEDICAL PRACTICE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIA PARK MD (OWNER)
(718) 229-4090
Entity
Organization
Contact information
Practice address
21008 35TH AVE, BAYSIDE, NY 11361-1431
(718) 229-4090
(866) 457-6793
Mailing address
21008 35TH AVE, BAYSIDE, NY 11361-1431
(718) 229-4090
(866) 457-6793
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
174400000X
Specialist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/28/2011
Last updated
03/19/2021
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