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Individual

DR. KYONG PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., M.P.H.

Contact information

Practice address
360 BINNEY ST, CAMBRIDGE, MA 02142-1011
(571) 353-0256
Mailing address
PO BOX 514, GREAT FALLS, VA 22066-0514
(518) 285-0864

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R-8207
IA
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
0101244536
VA
2083P0901X
Public Health & General Preventive Medicine Physician
253655
NY

Other

Enumeration date
07/10/2007
Last updated
10/25/2020
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