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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 3 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 1609141373 NPPES
New York MEDICAID 03581459
New York Other 1609141373

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