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1386028561
JEONGSOO PARK
JAMAICA, NY
NPI
1386028561
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2015-07-16
Last Update Date
2015-07-16
Business Address
-- JEONGSOO PARK
8268 164TH ST
JAMAICA, NY 11432-1121
Phone number: 929-264-1293
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Mailing Address
-- JEONGSOO PARK
4227 213TH ST
BAYSIDE, NY 11361-2854
Phone number: 929-264-1293
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