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Organization

WOODSIDE MEDICAL REHABILITATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAE O PARK MD (MD)
(718) 986-5841
Entity
Organization

Contact information

Practice address
14370 SANFORD AVE, FLUSHING, NY 11355-2044
(718) 886-6268
Mailing address
14370 SANFORD AVE, FLUSHING, NY 11355-2044
(718) 886-6268

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
130080-1
NY

Other

Enumeration date
02/23/2007
Last updated
08/22/2020
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