Most Relevant Information
Provider Data
| NPI Number: | 1003519844 |
| Provider Name: | JOO-EUN SAMUEL PARK MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/22/2023 |
| Last Updated: | 03/22/2023 |
Provider Practice Location
27005 76TH AVE
NEW HYDE PARK
NY
110401402
Practice Location Phone/Fax
| Phone: | 7184705382 |
| Fax: |
Provider Mailing Location
27005 76TH AVE
NEW HYDE PARK
NY
110401402
Provider Mailing Phone/Fax
| Phone: | 7184705382 |
| Fax: |