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NPI Code Detail

MEDICARE: SE HYUK PARK MD

MEDICARE: SE HYUK PARK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1275473282
Entity Type Code : Individual
Provider Name (Legal Business Name) : SE HYUK PARK MD
Provider Business Mailing Address
First Line : 462 GRIDER ST
Second Line :
City : BUFFALO
State : NY
Zip : 14215-3021
Country : US
Telephone Number : 716-898-3000
Fax Number :
Provider Business Practice Location Address
First Line : 462 GRIDER ST
Second Line :
City : BUFFALO
State : NY
Zip : 14215-3021
Country : US
Telephone Number : 716-898-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2026
Last Update Date : 04/21/2026

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Directions to “ SE HYUK PARK MD” Practice Location

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