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Individual

SUNG UK PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
22001 JAMAICA AVE FL 2, QUEENS VILLAGE, NY 11428-2140
(646) 644-7580
Mailing address
21532 35TH AVE, BAYSIDE, NY 11361-1702
(646) 644-7580

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006508
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
162976968
DRIVER LICENSE NUMBER
NY
Enumeration date
05/11/2019
Last updated
05/11/2019
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