Organization
BAYSIDE PAIN & REHABILITATION MEDICINE, P.C.
Active
Other names
(DBA) Dr. Park's Comprehensive Pain Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KI YOUNG PARK M.D. (PRESIDENT)
(718) 463-1133
Entity
Organization
Contact information
Practice address
142-29 37 AVE., (BASEMENT), FLUSHING, NY 11354
(718) 463-1133
(718) 463-6392
Mailing address
142-29 37 AVE., (BASEMENT), FLUSHING, NY 11354
(718) 463-1133
(718) 463-6392
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200978
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P-904065
OXFORD
NY
Enumeration date
02/19/2009
Last updated
06/02/2009
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