DR. TAE PARK (NPI# 1932141942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932141942 |
| Entity Type | Individual |
| Full Name | DR. TAE PARK |
| Credential | M.D. |
| Practice Address |
University Hospital L2 Stony Brook NY 11794-0001 |
| Mailing Address |
Po Box 1559 Stony Brook NY 11790-0989 |
| Practice Telephone | 6314442210 |
| Mailing Telephone | 6314442210 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
155585 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | EMPIRE B/C B/S | 43D181 | 01 |
| NY | AETNA | 4664533 | 01 |
| NY | 00893265 | 05 |
| 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 |
| 1093940249 | Tae Keun Park | Emergency Medicine | 300 Community Dr, Department of Emergency Medicine, Manhasset, NY 11030-3816 | 2009-05-18 |
| 1043308984 | Tae Park | Pharmacist | 1450 Chapel St, Pharmacy Department, New Haven, CT 06511-4405 | 2006-10-10 |
| Street Address |
UNIVERSITY HOSPITAL L2 |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144268756 | Wyman Bethune | Radiology | University Hospital L2, Stony Brook, NY 11794-0001 | 2006-06-04 |
| 1710920806 | Tamara Weiss | Radiology | University Hospital L2, Stony Brook, NY 11794-0001 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619506714 | Ryan John Kottmeier | Physician Assistant | 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 | 2020-04-02 |
| 1699302109 | Michael Trentalange | Student in an Organized Health Care Education/Training Program | Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 | 2020-03-25 |
| 1164985156 | Lauren Kate Harris | Student in an Organized Health Care Education/Training Program | Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 | 2019-04-08 |
| 1851851448 | Kathy Tin | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 | 2019-03-21 |
| 1174083703 | Arham Khan | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 | 2019-03-20 |
| 1396221982 | Aman Bhojani | Student in an Organized Health Care Education/Training Program | Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 | 2018-07-17 |
| 1699265629 | Belliny Phaeton | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-15 |
| 1629568969 | Rachel Herold | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-11 |
| 1598254419 | Nora Ann Diraimondo | Nurse Practitioner | Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 | 2018-05-07 |
| 1386140705 | Ryan Christopher Corn | Student in an Organized Health Care Education/Training Program | Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 | 2018-04-04 |
| Find all providers in zip 11794 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144586397 | Kartik M Mani | Radiology | 101 Nicolls Rd # L3-049, Stony Brook, NY 11794-2401 | 2012-04-02 |
| 1598992802 | Alexander Michael Stessin | Radiology | Dept of Radiation Oncology Stony Brook Univ, 101 Nicolls Rd, Stony Brook, NY 11794-7028 | 2009-06-12 |
| 1144268756 | Wyman Bethune | Radiology | University Hospital L2, Stony Brook, NY 11794-0001 | 2006-06-04 |
| 1093195281 | Alexander Slade | Radiology | 101 Nicolls Rd, Stony Brook, NY 11794-0001 | 2015-06-03 |
| 1336533249 | Mark Ashamalla | Radiology | 101 Nicolls Rd, Radiation Oncology, Level 2, Room 805, Stony Brook, NY 11794-7028 | 2015-03-28 |
| 1134396351 | Craig Eli Grossman | Radiology | 100 Nicolls Rd, Stony Brook, NY 11794-0001 | 2008-05-15 |
| 1639239049 | Samuel Ryu | Radiology | 101 Nicolls Rd, Levle 2 Radiation Oncology, Stony Brook, NY 11794-7028 | 2006-12-08 |
| 1710920806 | Tamara Weiss | Radiology | University Hospital L2, Stony Brook, NY 11794-0001 | 2006-06-14 |
| 1730126517 | Stony Brook Radiation Oncology, University Faculty Practice Corporatio | Radiology | Suny @ Stony Brook, Hsc, L2, Rm 643, Stony Brook, NY 11797 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053875229 | Msk Nassau | Radiology | 1101 Hempstead Turnpike, Uniondale, NY 11553 | 2019-01-22 |
| 1740733575 | Nr Physician Group, Pllc | Radiology | 3910 N Buffalo St, Orchard Park, NY 14127 | 2016-07-28 |
| 1639566516 | Fauzia Shaikh | Radiology | 525 E 68th St # 95, New York, NY 10065-4870 | 2015-04-18 |
| 1306231774 | Lucas Resende Salgado | Radiology | 370 Avenue U Apt 3, Brooklyn, NY 11223-4024 | 2015-04-02 |
| 1083008403 | Alan J. Katz, M.d., Pllc | Radiology | 1781 Hylan Blvd, Staten Island, NY 10305-1917 | 2015-03-24 |
| 1417368721 | Moses Min-chi Tam | Radiology | 550 1st Ave Fl 2, New York, NY 10016-6402 | 2014-05-09 |
| 1649690629 | Christine Chin | Radiology | 622 West 168th Street Chony North B-level, New York, NY 10032 | 2014-04-17 |
| 1336566272 | Stanislav Lazarev | Radiology | 1184 5th Avenue, First Floor, Pm-124, New York, NY 10029-1002 | 2014-03-27 |
| 1548683022 | Metropolitan Radiation Oncology Consulting PC | Radiology | 686 Stoneleigh Ave., Carmel, NY 10512 | 2014-02-04 |
| 1295070845 | Ezzat T Youssef | Radiology | 5 Ridge Ave, Staten Island, NY 10304-1418 | 2012-12-09 |
| Find all providers with the same taxonomy | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
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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.