Kimberly Mae Leu Park, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

022715 Issued in NY

Practice address

750 Jennings St
Bronx, NY 10459-1204

Phone

(718) 378-0006

NPI assigned

Sep 11, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Mae Leu Yee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648944000000",
    "number": "1013490424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 JENNINGS ST RM 118",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104591204",
            "telephone_number": "718-378-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 JENNINGS ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104591204",
            "telephone_number": "718-378-0006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3636 33rd St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Long Island City",
            "state": "NY",
            "postal_code": "111062329",
            "country_code": "US",
            "telephone_number": "212-529-9780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "KIMBERLY",
        "middle_name": "MAE LEU",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2022-04-03",
        "certification_date": "2022-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "022715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "YEE",
            "middle_name": "MAE LEU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joy E Park, RPH
• Jung Park
• Jung Eun Park, MD
• Junghwan Park, M.D.
• Keun Hee Park, DDS
• Marisa G Park, PHARM D
• Mi NA Park, MD
• Mi Wha Park
• Michael Park, DDS
• Michelle Park, MD

• Occupational Therapist in Bronx, NY
• Providers in Bronx, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.