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General NPI Number Information
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NPI Number | 1033235312
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Entity Type | Individual
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Provider Name | HAESOOK PAIK N.P.
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Gender | Female
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 622 W 168TH ST PH 137 NY-PRESBYTERIAN HOSPITAL
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City | NEW YORK
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State | NY
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Zip | 10032-3720
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Country | US
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Telephone | 212-305-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 4140 UNION ST APT. 14E
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City | FLUSHING
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State | NY
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Zip | 11355-2540
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Country | US
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Telephone | 718-358-2038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F300202-1
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License Number State | NY
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