Individual
TAE K PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
724 8TH AVE, BROOKLYN, NY 11215-4204
(718) 768-8111
(718) 768-8111
Mailing address
724 8TH AVE, BROOKLYN, NY 11215-4204
(718) 768-8111
(718) 768-8111
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
152709
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00775604
—
NY
Enumeration date
09/27/2006
Last updated
10/11/2007
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