DR. TAE KEUN PARK (NPI# 1093940249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093940249 |
| Entity Type | Individual |
| Full Name | DR. TAE KEUN PARK |
| Credential | M.D. |
| Practice Address |
300 Community Dr Department of Emergency Medicine Manhasset NY 11030-3816 |
| Mailing Address |
718 Teaneck Rd Dept Of Teaneck NJ 07666-4245 |
| Practice Telephone | 5165622925 |
| Mailing Telephone | (201) 833-3913 |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 25MA08835000 | NJ | Allopathic & Osteopathic Physicians |
| N | 207PS0010X |
Emergency Medicine Specialization: Sports Medicine |
25MA08835000 | NJ | Allopathic & Osteopathic Physicians |
| N | 207PS0010X |
Emergency Medicine Specialization: Sports Medicine |
A104548 | CA | Allopathic & Osteopathic Physicians |
| N | 207PS0010X |
Emergency Medicine Specialization: Sports Medicine |
252574 | NY | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 718 Teaneck Rd, Teaneck, NJ 076664245 | 2018333913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710273156 | Tae Sook Park | Acupuncturist | 903 S. Crenshaw Blvd, 302, Los Angeles, CA 90019 | 2011-06-23 |
| 1790870996 | Tae H Park | Dentist | 1875 E Alluvial Ave, Suite 102, Fresno, CA 93720-3856 | 2006-10-04 |
| 1336230259 | Tae K Park | Internal Medicine | 724 8th Ave, Brooklyn, NY 11215-4204 | 2006-09-27 |
| 1376560805 | Tae Sung Park | Neurological Surgery | 1 Childrens Pl Fl 1, 1st Fl, Saint Louis, MO 63110-1002 | 2006-07-17 |
| 1346297660 | Tae J. Park | Internal Medicine | 512 W Rosedale St, Fort Worth, TX 76104-4619 | 2006-05-30 |
| 1538133020 | Tae Won Park | Psychiatry & Neurology | 1547 S Wayne Rd, Westland, MI 48186 | 2006-02-14 |
| 1275015364 | Tae Park | Pharmacist | 1640 Hopkins Rd, Williamsville, NY 14221-1752 | 2018-09-05 |
| 1669751772 | Tae E Park | Pharmacist | 230 Park Ave, M-sp1-01, Florham Park, NJ 07901 | 2011-08-05 |
| 1043308984 | Tae Park | Pharmacist | 1450 Chapel St, Pharmacy Department, New Haven, CT 06511-4405 | 2006-10-10 |
| 1932141942 | Tae Park | Radiology | University Hospital L2, Stony Brook, NY 11794-0001 | 2006-06-12 |
| Street Address |
300 COMMUNITY DR DEPARTMENT OF EMERGENCY MEDICINE |
| City | MANHASSET |
| State | NY |
| Zip Code | 11030-3816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487659777 | Rudy Neptune | Anesthesiology | 300 Community Dr, Manhasset, NY 11030-3816 | 2005-06-15 |
| 1013518935 | Vikram Gajulapalli | Pharmacist | 300 Community Dr, Manhasset, NY 11030-3816 | 2020-11-06 |
| 1568062396 | Caroline Smolenski | Nurse Anesthetist, Certified Registered | 300 Community Dr, Manhasset, NY 11030-3876 | 2020-10-30 |
| 1265031256 | James Jiwon Song | Pharmacy Technician | 300 Community Dr, Manhasset, NY 11030-3816 | 2020-10-20 |
| 1437757739 | Andy Sunwoo Lim | Pharmacy Technician | 300 Community Dr, Manhasset, NY 11030-3876 | 2020-10-09 |
| 1548867450 | Shiva Moshtagh | Nurse Practitioner | 300 Community Dr, Manhasset, NY 11030-3816 | 2020-10-04 |
| 1457968943 | Bryanna Colleen Kelly | Nurse Practitioner | 300 Community Dr, Manhasset, NY 11030-3816 | 2020-09-28 |
| 1902412463 | Tara Shelley | Physician Assistant | 300 Community Dr, Manhasset, NY 11030-3876 | 2020-09-21 |
| 1548875644 | Julius E Wilson Jr. | Pharmacy Technician | 300 Community Dr, Manhasset, NY 11030-3816 | 2020-09-15 |
| 1114532215 | Sarah Iqbal | Pharmacy Technician | 300 Community Dr, Manhasset, NY 11030-3816 | 2020-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831754126 | Diana Fox | Registered Nurse | 330 Community Drive, Manhasset, NY 11030 | 2019-05-02 |
| 1215470257 | Melissa Fackler | Registered Nurse | 1350 Northern Blvd Ste 202, Manhasset, NY 11030 | 2016-11-23 |
| 1821443391 | Sarah Javdan | Family Medicine | 800 Community Dr Ste 206, Manhasset, NY 11030 | 2016-05-03 |
| 1891167458 | Stacie Thaw Lcsw Pllc | Social Worker | 115 Park Ave., Manhasset, NY 11030 | 2015-10-22 |
| 1538547971 | Aarti Kumar | Podiatrist | 535 Plandome Rd # 2, Manhasset, NY 11030 | 2015-05-18 |
| 1073933586 | Rachel Durante | Occupational Therapist | 600 Community Drive, Manhasset, NY 11030 | 2014-04-23 |
| 1831436435 | Anesthesia Care, P.C. | General Practice | 565 Plandome Road, Manhasset, NY 11030 | 2013-01-16 |
| 1821350091 | Sylvia Yoonsun Kim | Pharmacist | 139 Vanderbilt Ave, Manhasset, NY 11030 | 2012-06-13 |
| 1699062588 | Rod Stern | Dentist | 444 Community Dr Ste 201, Manhasset, NY 11030 | 2011-06-30 |
| 1558654798 | Alexandria Pace Kress | Speech-Language Pathologist | 31 Circle Dr, Manhasset, NY 11030 | 2011-05-20 |
| Find all providers in zip 11030 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235390204 | Lincoln George Coffie | Emergency Medicine | 304 Community Dr, Apt 1d, Manhasset, NY 11030-3834 | 2008-06-22 |
| 1548398092 | Eduardo Del Rosario Enriquez | Emergency Medicine | 54 Brinkerhoff Ln, Manhasset, NY 11030-3102 | 2007-02-28 |
| 1821138447 | Le Kuan Fu | Emergency Medicine | 29 Allston Pl, Manhasset, NY 11030-2810 | 2007-02-06 |
| 1568532612 | Mathew Jared Nelson | Emergency Medicine | Nsuh Dept of Emergency Medicine, Nsuh Dept of Emergency Medicine 300 Community Drive, Manhasset, NY 11030 | 2006-11-08 |
| 1275603326 | Evan Meiner | Emergency Medicine | Nsuh-dept of Emergency Medicine, 300 Community Drive, Manhasset, NY 11030 | 2006-11-08 |
| 1609954023 | Richard D Susi | Emergency Medicine | 331 Park Ave, Manhasset, NY 11030-2416 | 2006-11-02 |
| 1740366673 | Mikaela B Anderson | Emergency Medicine | 300 Community Dr., Emergency Department, Manhasset, NY 11030 | 2006-10-31 |
| 1659803328 | Steven Johnson | Emergency Medicine | 300 Community Dr, Manhasset, NY 11030-3816 | 2017-03-31 |
| 1356796759 | Miles Phillip Gordon | Emergency Medicine | 300 Community Dr, Manhasset, NY 11030-3816 | 2016-05-04 |
| 1871957977 | Lauren Theresa Cooke-sporing | Emergency Medicine | 300 Community Dr, Dept of Emergency Medicine, Attn: Toni Borheck, Manhasset, NY 11030-3816 | 2016-04-05 |
| Find all providers in MANHASSET | ||||
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| 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.