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General NPI Number Information
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NPI Number | 1992175905
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Entity Type | Individual
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Provider Name | YOUNG HO PARK L.AC
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Gender | Male
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 37 CONGERS RD FL 1
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City | NEW CITY
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State | NY
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Zip | 10956-5135
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Country | US
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Telephone | 718-637-4780
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Fax |
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Provider Business Mailing Address
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Address Line | 2 HORIZON RD APT 1027
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City | FORT LEE
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State | NJ
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Zip | 07024-6531
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Country | US
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Telephone | 718-637-4780
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 005628
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License Number State | NY
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