DR. SAMUEL JOON PARK


Address: 160 1st St Unit 551, Mineola, NY 11501-5025
Phone: 5166198098

DR. SAMUEL JOON PARK (NPI# 1053607952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053607952
Entity Type Individual
Full Name DR. SAMUEL JOON PARK
Credential M.D.
Practice Address 160 1st St Unit 551
Mineola
NY 11501-5025
Practice Telephone 5166198098
Mailing Telephone 5166198098
Enumeration Date 2011-06-20
Last Update Date 2019-06-06
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine CDRH.0057133 CO Allopathic & Osteopathic Physicians
Y 207R00000X Internal Medicine 01081067A IN Allopathic & Osteopathic Physicians
N 207R00000X Internal Medicine 28444 WV Allopathic & Osteopathic Physicians
N 207R00000X Internal Medicine 285562 NY Allopathic & Osteopathic Physicians
N 208000000X Pediatrics 285562 NY Allopathic & Osteopathic Physicians
N 208000000X Pediatrics CDRH.00571 CO Allopathic & Osteopathic Physicians

Other Providers SAMUEL PARK

NPI Name Taxonomy Address Enumeration
1922363183 Samuel Park Preventive Medicine 2448 Historic Decatur Rd Ste 130, San Diego, CA 92106-6127 2012-07-12
1851504377 Samuel Sanghong Park Orthopaedic Surgery 12 Salt Creek Ln Ste 350, Hinsdale, IL 60521-8612 2007-05-08
1023174752 Samuel Ryan Park Anesthesiology 22 Odyssey Ste 155, Irvine, CA 92618-3194 2006-12-28
1497832661 Samuel K. Park Family Medicine 20072 Sw Birch St Ste 100, Newport Beach, CA 92660-0794 2006-11-01
1740285907 Samuel Mo Park Physical Medicine & Rehabilitation 340 W East Ave, Chico, CA 95926-7238 2005-06-15
1124551239 Samuel Park Student in an Organized Health Care Education/Training Program 1959 Ne Pacific St, Bb-1469, Seattle, WA 98195-0001 2017-04-05
1154853836 Samuel Park Physical Therapist 5000 W National Ave, Milwaukee, WI 53295-0001 2017-03-31
1790237899 Samuel Park Student in an Organized Health Care Education/Training Program 3580 Wilshire Blvd Fl 8, Los Angeles, CA 90010-2505 2016-10-25
1295187136 Samuel Park IIi Physical Medicine & Rehabilitation 1240 Mckee Rd, Dover, DE 19904-1381 2016-07-03
1205222510 Samuel Park Psychologist 1201 Broad Rock Blvd, Richmond, VA 23249-0001 2015-04-13

Office Location

Street Address 160 1ST ST UNIT 551
City MINEOLA
State NY
Zip Code 11501-5025

Providers in the same location

NPI Name Taxonomy Address Enumeration
1225587793 Samuel Park Md, Pllc Pediatrics 160 1st St Unit 551, Mineola, NY 11501-5025 2016-09-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1710500350 Steve Abraham Simon Student in an Organized Health Care Education/Training Program 222 Station Plaza, Suite 509, Mineola, NY 11501 2020-05-18
1407478167 Frederick Milton Bosoy Student in an Organized Health Care Education/Training Program 259 1st St, Mineola, Ny 11501, Mineola, NY 11501 2020-05-15
1982226130 Katelyn Anne Fowler Counselor [email protected], 410 East Jericho Tpke, Mineola, NY 11501 2020-05-11
1225667819 New York Dialysis Services, Inc Clinic/Center 1 East Jericho Turnpike, Mineola, NY 11501 2020-04-06
1518500032 Irina Victoria Kushnareva Social Worker 126 Saville Rd, Mineola, NY 11501 2019-10-28
1861046336 Milagros M Matias Case Manager/Care Coordinator 39 E. Jericho Turnpike, Mineola, NY 11501 2019-08-01
1154974244 Bahram Dabiri Student in an Organized Health Care Education/Training Program 222 Station Plaza N., Suite 620 Mineola, Mineola, NY 11501 2019-07-18
1972168748 Nabeel A. Arain Physician Assistant 251 1st St., Mineola, NY 11501 2019-05-07
1598328940 Ramsha Jabbar Student in an Organized Health Care Education/Training Program 222 Station Plaza North, Suite 305, Mineola, NY 11501 2019-04-20
1235628850 Valentyna Erstenyuk Student in an Organized Health Care Education/Training Program 222 Station Plaza N, Suite 611, Mineola, NY 11501 2018-05-09
Find all providers in zip 11501

Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023577798 New York University Internal Medicine 300 Old Country Rd Ste 103, Mineola, NY 11501-4112 2019-03-13
1467711507 Niti Rajpal Internal Medicine 222 Station Plz N Ste 310, Mineola, NY 11501-3893 2012-05-10
1447516356 Sigridh Alicia Munoz Gomez Internal Medicine 222 Station Plz N Ste 432, Mineola, NY 11501-3893 2012-04-04
1902115363 Jessica Widmer Internal Medicine 276 1st St Apt 1k, Mineola, NY 11501-2366 2010-10-04
1003049867 Anitha Sara Mathew-shaji Internal Medicine 300 Old Country Rd Ste 31, Mineola, NY 11501-4112 2009-08-27
1689803736 Dmitriy O. Khodorskiy Internal Medicine 222 Station Plz N Ste 429, Mineola, NY 11501-3889 2009-07-10
1699914234 Irum Anwar Chaudhry Internal Medicine 131 Marcellus Rd, Mineola, NY 11501-2327 2009-02-04
1821236696 Jacob Babu Internal Medicine 155 Latham Rd, Mineola, NY 11501-2241 2009-02-01
1407091242 Alan Wong Internal Medicine 146 Emory Rd, Mineola, NY 11501-2349 2008-12-09
1396906483 Scott D Freeman Internal Medicine 222 Station Plz N Ste 605, Mineola, NY 11501-3893 2008-06-20
Find all providers in MINEOLA

Competitor

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City MINEOLA
Zip Code 11501

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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