Pak, Kevin I

Pak, Kevin I is an individual health care provider with primary practice located at 7206 Northern Blvd 2Nd Floor, Jackson Heights NY 11372-1049. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Pak, Kevin I can be contacted via phone (866) 670-6824.

Contact Information

Primary practice address
7206 Northern Blvd 2Nd Floor Jackson Heights NY 11372-1049
Phone: (866) 670-6824
Fax: (178) 533-1774
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X MT184507 Pennsylvania
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X 247616-B18 New York

Profile Details

NPI number 1508922527
LBN Legal business name Pak, Kevin I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Dec 6th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508922527 NPPES
New York MEDICAID 03143491

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