SEOUNG SOU PARK (NPI# 1902948193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902948193 |
| Entity Type | Individual |
| Full Name | SEOUNG SOU PARK |
| Credential | MD |
| Practice Address |
105 Stevens Avenue Suite 310 Mount Vernon NY 10550-2686 |
| Practice Telephone | 9146636635 |
| Practice Fax Number | 9146636637 |
| Mailing Telephone | 9146636635 |
| Mailing Fax Number | 9146636637 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
197192 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | EMPIRE BCBS | 21N461 | 01 |
| AETNA | 7464117 | 01 | |
| OXFORD HEALTH PLAN | P1229667 | 01 | |
| NY | 01729675 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447469747 | Seoung Hyon Park | Denturist | 8717 South Tacoma Way, Lakewood, WA 98499 | 2007-05-22 |
| Street Address |
105 STEVENS AVENUE SUITE 310 |
| City | MOUNT VERNON |
| State | NY |
| Zip Code | 10550-2686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508400961 | Aiyana Amaris Matondo | Occupational Therapy Assistant | 105 Stevens Avenue, Mount Vernon, NY 10550 | 2019-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487240 | Jacqueline Marshall | Technician | 144 South 2nd Avenue 2c, Mount Vernon, West Chester, NY 10550 | 2020-05-05 |
| 1023529369 | B.t.m. Psychiatric Np Services, Pllc | Nurse Practitioner | 11 W Prospect Ave, 3rd Fl, Suite #5b, Mount Vernon, NY 10550 | 2017-10-13 |
| 1669994174 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 500 E Sanford Blvd, Mount Vernon, NY 10550 | 2017-07-17 |
| 1053869198 | Teresa Turriago I | Social Worker | 487 S. Broadway, Yonkers, New York, NY 10550 | 2016-09-19 |
| 1811340862 | Marcia Samuels Nembhard | Licensed Practical Nurse | 1 Gray Place Apt 4-d, Mount Vernon, NY 10550 | 2016-07-14 |
| 1043665318 | Marshalee Mullings | Registered Nurse | 70 E 4th Street, 2c, Mount Vernon, NY 10550 | 2016-04-25 |
| 1518333228 | Humanities Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 100 Stevens Avenue, Mount Vernon, NY 10550 | 2015-08-17 |
| 1851779458 | Maila Catolico | Registered Nurse | 9 West Prospect Avenue, Suite 310, Mount Vernon, NY 10550 | 2015-05-14 |
| 1003203266 | Priscilla A. Severe | Registered Nurse | 9 West Prospect Avenue, Suite 310, Mount Vernon, NY 10550 | 2015-04-24 |
| 1477963254 | Imani Ife Campbell | Licensed Practical Nurse | 323 South 10th Ave, Mt. Vernon, NY 10550 | 2014-05-02 |
| Find all providers in zip 10550 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| 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 |
|---|---|---|---|---|
| 1306144506 | James Neal Greene | Internal Medicine | 1259 Pine Dr, Mount Vernon, MO 65712-0145 | 2011-03-11 |
| 1013334556 | Sikarin Upala | Internal Medicine | 4101 N Water Tower Pl, Mount Vernon, IL 62864 | 2014-03-22 |
| 1790949006 | Jaime T Goodman | Internal Medicine | 307 Vernedale Dr, Mount Vernon, OH 43050-2921 | 2008-07-16 |
| 1558427492 | Nora H Farkouh | Internal Medicine | 107 West 4th Street, Mount Vernon, NY 10550 | 2006-12-28 |
| 1841266285 | Vince N Montes | Internal Medicine | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2006-02-26 |
| 1396737326 | George J. Ang | Internal Medicine | 1400 E Kincaid St, Skagit Regional Clinics, Mount Vernon, WA 98274-4127 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271629 | Cecelia Health, Inc. | Internal Medicine | 355 Lexington Ave # 12f, New York, NY 10017-6603 | 2020-10-02 |
| 1679199608 | Mount Sinai School of Medicine | Internal Medicine | 2209 Merrick Rd Ste 100, Merrick, NY 11566-4770 | 2020-06-25 |
| 1033677810 | Sarah Fishman Md, Phd PC | Internal Medicine | 121 E 60th St Apt 3b, New York, NY 10022-1164 | 2019-03-11 |
| 1861969404 | Mt Endocrinology PC | Internal Medicine | 984 N Broadway Ste 305, Yonkers, NY 10701-1308 | 2018-11-01 |
| 1306389523 | Dina Zaqqa | Internal Medicine | 76 Adams Rd, Saratoga Springs, NY 12866-9008 | 2016-11-19 |
| 1740731876 | Beth Anne Piper | Internal Medicine | 104 Union Ave Ste 801, Syracuse, NY 13203-1844 | 2016-10-24 |
| 1023487394 | Michael Berelowitz | Internal Medicine | 415 E 37th St Apt 36c, New York, NY 10016-3261 | 2015-09-17 |
| 1316326317 | Westchester Endrocrinology Pllc | Internal Medicine | 265 Hardscrabble Rd, Briarcliff Manor, NY 10510-1802 | 2015-05-22 |
| 1730577602 | Nicseb Medical PC | Internal Medicine | 103 W 117th St, Ph, New York, NY 10026-2963 | 2014-12-31 |
| 1962812529 | Maria Teresa Anton | Internal Medicine | 9965 64th Rd Apt 5f, Rego Park, NY 11374-2684 | 2014-05-05 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT VERNON |
| Zip Code | 10550 |
Please comment or provide details below to improve the information on SEOUNG SOU PARK.
| 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.