Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 252737 | NY |
N | 207RA0201X | Internist - Allergy & Immunology | 252737-1 | NY |
NPI | 1447314331 |
---|---|
Provider Name | Joon Hong Park |
First Address | Tarrytown, NY 10591-5139 |
Second Address | Middletown, NY 10941-7000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2006 |
Last Update Date | 03/04/2019 |