DR. TINA PARK (NPI# 1821226101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821226101 |
| Entity Type | Individual |
| Full Name | DR. TINA PARK |
| Credential | M.D. |
| Practice Address |
622 W 168th St New York NY 10032-3720 |
| Mailing Address |
630 W 168th St New York NY 10032-3725 |
| Practice Telephone | 2123424776 |
| Mailing Telephone | 2123425155 |
| Mailing Fax Number | 4014442947 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2019-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | LP01591 | RI | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
277511 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | NYS MED LICENSE | 277511 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407200694 | Tina Keun Nan Park | Dentist | 962 Calle Amable, Glendale, CA 91208-3062 | 2016-04-14 |
| 1174806772 | Tina Park | Pharmacist | 3 E. Golf Road, Arlington Heights, IL 60005 | 2011-09-21 |
| 1265971048 | Tina Park | Student in an Organized Health Care Education/Training Program | 111 E 210th St, Bronx, NY 10467-2401 | 2017-02-14 |
| Street Address |
622 W 168TH ST |
| City | NEW YORK |
| State | NY |
| Zip Code | 10032-3720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982608493 | Eastside Orthotics and Prosthetics, Inc. | Durable Medical Equipment & Medical Supplies | 622 W 168th St, Vc333, New York, NY 10032 | 2005-06-13 |
| 1790386399 | Carl Elliston | Radiology | 622 W 168th St, Department of Radiation Oncology, New York, NY 10032 | 2020-11-02 |
| 1275140758 | Alyssa Hope Diaz | Nurse Practitioner | 622 W 168th St, New York, NY 10032-3720 | 2020-09-28 |
| 1295341873 | Ann Mchugh | Obstetrics & Gynecology | 622 W 168th St, New York, NY 10032-3720 | 2020-09-19 |
| 1821604778 | Kellie Kolessar | Physician Assistant | 622 W 168th St, New York, NY 10032-3720 | 2020-09-16 |
| 1912525833 | Fanny Ok | Physician Assistant | 622 W 168th St, New York, NY 10032-3720 | 2020-07-07 |
| 1982221644 | Ashley D Gandhi | Physician Assistant | 622 W 168th St, New York, NY 10032-3720 | 2020-06-29 |
| 1891311080 | Demond Harrison | Respiratory Therapist, Registered | 622 W 168th St, New York, NY 10032-3720 | 2020-06-23 |
| 1073136115 | Dennis Man | Pharmacist | 622 W 168th St, New York, NY 10032-3720 | 2020-05-23 |
| 1205457801 | Adam Sands | Student in an Organized Health Care Education/Training Program | 622 W 168th St, New York, NY 10032-3720 | 2020-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658301 | Julia Sophia White | Registered Nurse | 622 W 168th St, New York, Ny, New York, NY 10032 | 2020-10-29 |
| 1326653411 | Simbarashe S Mudiwa | Massage Therapist | 615 W 165th St, Apt 1b, New York, NY 10032 | 2020-09-15 |
| 1063021335 | Margaret E O'neil | Physical Therapist | 180 Fort Washington St, Harkness 1-164, New York, NY 10032 | 2020-07-23 |
| 1780207480 | Bing Mei Teh | Student in an Organized Health Care Education/Training Program | 180 Fort Washington Ave, Harkness Pavillion 7th Floor, Department of Otolaryngology, New York, NY 10032 | 2020-05-28 |
| 1295354116 | Kavin Fatehchand | Student in an Organized Health Care Education/Training Program | 630 West 168th Street, New York, Ny 10032, New York, NY 10032 | 2020-04-10 |
| 1417584020 | Laura Faye Willard | Student in an Organized Health Care Education/Training Program | 177 Ft. Washington Ave., 7gs-313, New York, NY 10032 | 2020-03-24 |
| 1356976641 | Thomas Joseph Cahill | Student in an Organized Health Care Education/Training Program | Columbia Heart & Valve Center, New York Presbyterian/co, 161 Fort Washington Avenue, Herbert Irving Pavilion 6 F, New York City, NY 10032 | 2020-03-06 |
| 1346874765 | Paulo Roberto De Paula Selber | Orthopaedic Surgery | Department of Orthopedic Surgery - Chony, 3959 Broadway, 8 North, Room 803, New York, NY 10032 | 2020-02-25 |
| 1720611312 | Rachel Dawn Vanderlaan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Newyork-presbyterian Morgan Stanley Children's Hospital, 3959 Broadway Ave Suite: 274, New York, NY 10032 | 2020-02-21 |
| 1881225928 | Daniel Molina Garcia | Social Worker | 180 Fort Washingtion Avenue, 6th Fl, New York, NY 10032 | 2020-01-28 |
| Find all providers in zip 10032 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487279725 | Akifa Samdani, Md PC | Internal Medicine | 120 E 86th St # 2b, New York, NY 10028-1062 | 2020-06-12 |
| 1669005690 | Ron Porat Jankelson | Internal Medicine | 200 E 64th St Apt 10b, New York, NY 10065-7441 | 2020-02-18 |
| 1225490477 | Lawrence Franklin Braly | Internal Medicine | 114 Horatio St, 310, New York, NY 10014-1574 | 2016-03-27 |
| 1740693589 | Yaniuska Lescaille | Internal Medicine | 630 W 168th St Rm P&s3-401, New York, NY 10032-3725 | 2014-06-10 |
| 1003233966 | Kohtaro Ooka | Internal Medicine | 530 1st Ave # Hcc4g, New York, NY 10016-6402 | 2014-03-27 |
| 1700201449 | Centre Street Surgery Pllc | Internal Medicine | 139 Centre St Ste 609, New York, NY 10013-4556 | 2014-03-04 |
| 1063844256 | John Chi To Wong | Internal Medicine | 1233 York Ave Apt 15p, New York, NY 10065-6342 | 2013-07-30 |
| 1851735419 | Jonathan Dov Weinberger | Internal Medicine | 145 E 32nd St Fl 3, New York, NY 10016-6055 | 2013-04-24 |
| 1043585227 | Jordan Eric Axelrad | Internal Medicine | 240 E 38th St Fl 23, New York, NY 10016 | 2012-03-20 |
| 1841562758 | Aaa Gastrointestinal PC | Internal Medicine | 499 Fort Washington Ave, Suite Pe1c, New York, NY 10033 | 2012-02-08 |
| Find all providers in NEW YORK | ||||
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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.