Park, Kie Jung

Park, Kie Jung is an individual health care provider with primary practice located at 562 Wyoming Ave , Kingston PA 18704. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Park, Kie Jung can be contacted via phone (570) 552-3900.

Contact Information

Primary practice address
562 Wyoming Ave Kingston PA 18704
Phone: (570) 552-3900
Fax: (570) 552-3907
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X MD033477L Pennsylvania
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X MD033477L Pennsylvania
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD033477L Pennsylvania

Profile Details

NPI number 1477596088
LBN Legal business name Park, Kie Jung
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Oct 2nd, 2009 - about 16 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 1477596088 NPPES
Pennsylvania MEDICAID 007338991

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