Park, Jia
Park, Jia is an sole proprietor health care provider with primary practice located at 210-08 35Th Avenue , Bayside NY 11361-2979. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Park, Jia can be contacted via phone (718) 229-4090.Contact Information
Primary practice address
210-08 35Th Avenue
Bayside NY 11361-2979
Phone: (718) 229-4090
Fax: (718) 224-4131
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 214047 | New York |
Profile Details
| NPI number | 1588774921 |
|---|---|
| LBN Legal business name | Park, Jia |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Feb 14th, 2017 - about 8 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 | 1588774921 | NPPES |
| New York | MEDICAID | 02180216 |
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