Individual
JAE HONG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-4048
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
247263
NY
207R00000X
Internal Medicine Physician
L-224506
MA
207RH0003X
Hematology & Oncology Physician
Primary
726324
NY
Other
Enumeration date
04/03/2007
Last updated
07/19/2011
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