Individual
JEA YOUNG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 DIVISION ST, DERBY, CT 06418-1326
(203) 732-7327
Mailing address
130 DIVISION ST, DERBY, CT 06418-1326
(203) 732-7327
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A186360
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2019
Last updated
08/01/2025
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