Individual
SOON JOHN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
319 S MANNING BLVD STE 110A, ALBANY, NY 12208-1743
(518) 525-2525
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
294105
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609723500
—
MN
Enumeration date
07/21/2006
Last updated
10/20/2022
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