Park, Hyoungsup
Park, Hyoungsup is an individual health care provider with primary practice located at 599 Famington Ave , Farmington CT 06032. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Park, Hyoungsup can be contacted via phone (608) 284-4945.Contact Information
Primary practice address
599 Famington Ave
Farmington CT 06032
Phone: (608) 284-4945
Fax: (860) 284-4946
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 223132 | Massachusetts |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 200492 | Louisiana |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 043254 | Connecticut |
Profile Details
| NPI number | 1174512735 |
|---|---|
| LBN Legal business name | Park, Hyoungsup |
| Credentials | M.D., PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2005 |
| Last updated | Mar 31st, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174512735 | NPPES |
| Connecticut | MEDICAID | 008004410 |
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