Individual
BUMSOO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 W 31ST ST FL 3, NEW YORK, NY 10001-2861
(646) 987-3436
(646) 293-1441
Mailing address
700 HICKSVILLE RD, BETHPAGE, NY 11714-3471
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
336914
NY
207Q00000X
Family Medicine Physician
4301108105
MI
Other
Enumeration date
06/15/2015
Last updated
06/26/2025
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