Individual
KEVIN I PAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7206 NORTHERN BLVD, 2ND FLOOR, JACKSON HEIGHTS, NY 11372-1049
(866) 670-6824
(178) 533-1774
Mailing address
7206 NORTHERN BLVD, 2ND FLOOR, JACKSON HEIGHTS, NY 11372-1049
(866) 670-6824
(178) 533-1774
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
MT184507
PA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
247616-B18
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03143491
—
NY
Enumeration date
12/28/2006
Last updated
10/09/2025
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