Individual
GLORIA K PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
888 OLD COUNTRY RD, PLAINVIEW, NY 11803-4914
(516) 719-3000
Mailing address
1345 RXR PLZ, UNIONDALE, NY 11556-1301
(516) 453-0435
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
298847
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2016
Last updated
07/01/2019
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