Park, Sae-Lyoung
Park, Sae-Lyoung is an sole proprietor health care provider with primary practice located at 143-08 Roosevelt Ave. Apt L4, Flushing NY 11354. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Park, Sae-Lyoung can be contacted via phone (718) 939-3220.Contact Information
Primary practice address
143-08 Roosevelt Ave. Apt L4
Flushing NY 11354
Phone: (718) 939-3220
Fax: (718) 939-3440
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | N006468 | New York |
Profile Details
NPI number | 1609141373 |
---|---|
LBN Legal business name | Park, Sae-Lyoung |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Mar 14th, 2012 |
Last updated | Aug 29th, 2023 - 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 | 1609141373 | NPPES |
New York | MEDICAID | 03581459 | |
New York | Other | 1609141373 |
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