Kyung Sun Park, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

157978 Issued in NY

Practice address

100 Stevens Ave
7TH Floor
Mount Vernon, NY 10550-2600

Phone

(914) 668-6366

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sound Shore Physician Services

  • Clinic/Center
  • New Rochelle, NY
  • NPI 1689883068
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1114951522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STEVENS AVENUE",
            "address_2": "7TH FLOOR",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502026",
            "telephone_number": "914-668-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STEVENS AVE",
            "address_2": "7TH FLOOR",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502600",
            "telephone_number": "914-668-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "KYUNG",
        "middle_name": "SUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "157978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00841103",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edwin Pan, MD
• Natia Pantsulaia
• Sopha Janel Parande
• Patricia Parchment-Falconer
• Boma Park, MD
• Seoung Sou Park, MD
• Erica Parker-Jackson
• Frederick Lawrence Parker, MD
• Ramona J Parker
• Stephanie Parker, CNM

• Obstetrics & Gynecology Physician in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.