Individual
MR. KI YOUNG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14229 37TH AVE, BASEMENT, FLUSHING, NY 11354-4102
(718) 463-1133
(718) 463-6392
Mailing address
14229 37TH AVE, BASEMENT, FLUSHING, NY 11354-4102
(718) 463-1133
(718) 463-6392
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
200978
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P904065
OXFORD
—
Enumeration date
02/07/2007
Last updated
11/18/2009
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