Individual
JIYEON PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2534 CRESCENT ST APT 2E, ASTORIA, NY 11102-2925
(718) 730-2601
Mailing address
2534 CRESCENT ST APT 2E, ASTORIA, NY 11102-2925
(718) 730-2601
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F310534-01
NY
Other
Enumeration date
11/27/2021
Last updated
11/27/2021
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