Park, Malsuk

Park, Malsuk is an individual health care provider with primary practice located at 33-57 Harrison St , Johnson City NY 13790-2107. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Park, Malsuk can be contacted via phone (607) 763-6412.

Contact Information

Primary practice address
33-57 Harrison St Johnson City NY 13790-2107
Phone: (607) 763-6412
Fax: (607) 763-5854
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 25MB06993400 New Jersey
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 209345 New York

Profile Details

NPI number 1902890759
LBN Legal business name Park, Malsuk
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2005
Last updated Aug 20th, 2015 - about 9 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 1902890759 NPPES
New Jersey MEDICAID 8094501

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