Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 016112-1 | NY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 46TR00375100 | NJ |
NPI | 1326557711 |
---|---|
Provider Name | Suyun Kim-Park |
First Address | New York, NY 10032-3720 |
Second Address | New York, NY 10032-3720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2017 |
Last Update Date | 25/03/2020 |