Park, Seoung Sou

Park, Seoung Sou is an individual health care provider with primary practice located at 105 Stevens Avenue Suite 310, Mount Vernon NY 10550-2686. He recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as his primary health care specialty. Park, Seoung Sou can be contacted via phone (914) 663-6635.

Contact Information

Primary practice address
105 Stevens Avenue Suite 310 Mount Vernon NY 10550-2686
Phone: (914) 663-6635
Fax: (914) 663-6637
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 197192 New York

Profile Details

NPI number 1902948193
LBN Legal business name Park, Seoung Sou
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2007
Last updated Jul 8th, 2007 - about 17 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 1902948193 NPPES
Other P1229667 OXFORD HEALTH PLAN
Other 21N461 OXFORD HEALTH PLAN
Other 7464117 OXFORD HEALTH PLAN
MEDICAID 01729675 OXFORD HEALTH PLAN

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