Individual
DOO SIK PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40 44 82ND STREET, ELMHURST, NY 11373-1305
(718) 429-3800
(718) 429-4224
Mailing address
40 44 82ND STREET, ELMHURST, NY 11373-1305
(718) 429-3800
(718) 429-4224
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
136902
NY
208000000X
Pediatrics Physician
136902
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00545120
—
NY
01
—
92F131
EMPIRE BLUE CHOICE PPO
NY
01
—
92F132
EMPIRE BCBS
NY
Enumeration date
12/19/2006
Last updated
09/11/2025
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