Individual
DR. SAE-LYOUNG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
143-08 ROOSEVELT AVE., APT L4, FLUSHING, NY 11354
(718) 939-3220
(718) 939-3440
Mailing address
143-08 ROOSEVELT AVE., APT L4, FLUSHING, NY 11354
(718) 939-3220
(718) 939-3440
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N006468
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03581459
—
NY
01
—
1609141373
MEDICARE
NY
Enumeration date
03/14/2012
Last updated
08/29/2023
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