Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 25MA07120600 | NJ |
Y | 2081P2900X | Pain Medicine | MD421553 | PA |
NPI | 1154368819 |
---|---|
Provider Name | Yong I Park |
First Address | Langhorne, PA 19047-0606 |
Second Address | Fairless Hills, PA 19030-2624 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 30/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10451377 | (05) | PA |
1193693 | AETNA (01) | NJ |
1216431 | AETNA (01) | PA |
1630169 | HIGHMARK BLUE SHIELD (01) | PA |
1761794 | AETNA (01) | PA |
22-1994560 | FIRST MCO (01) | NJ |
2306074000 | KHPE, PERSONAL CHOICE, AMERIHEALTH (01) | PA |
23-2919275 | DEVON (01) | PA |
23-2919275 | FIRST MCO (01) | PA |
23-2919275 | GREAT WEST HEALTHCARE (01) | PA |
23-2919275 | HEALTH AMER./HEALTH ASS. (01) | PA |
23-2919275 | HEALTH AMERICA/HEALTH ASSURANCE (01) | PA |
23-2919275 | HORIZON BCBS OF NJ (01) | NJ |
23-2919275 | PROCURA MANAGEMENT (01) | PA |
23-2919275 | UNITED HEALTHCARE/OXFORD (01) | NJ |
23-2919275 | UNITED HEALTHCARE/OXFORD (01) | PA |
23-2993867 | DEVON (01) | PA |
23-2993867 | FIRST MCO (01) | PA |
23-2993867 | UNITED HEALTHCARE/OXFORD (01) | NJ |
23-2993867 | UNITED HEALTHCARE/OXFORD (01) | PA |
3252773 | CIGNA (01) | PA |
50062619 | CAPITAL BLUE CROSS (01) | PA |
50067193 | CAPITAL BLUE CROSS (01) | PA |
5747002 | FIRST HEALTH NETWORK (01) | PA |
999308 | UPMC HEALTH PLAN (01) | PA |
C0838608 | BRAVO (01) | PA |
H34612 | (02) | PA |
P00451411 | RAILROAD MEDICARE (01) | PA |
P3656794 | OXFORD (01) | PA |