Ny Family Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NY FAMILY MEDICINE PC

Practice address

14809 Northern Blvd Ste 1K
Flushing, NY 11354-4308

Phone

(347) 506-0325

Fax

(347) 506-0314

NPI assigned

Aug 8, 2022

Last updated

Aug 8, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel Doyoung Park, DO

Title

Owner

Phone

(347) 506-0325

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1205563319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14809 NORTHERN BLVD STE 1K",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544308",
            "telephone_number": "347-506-0325",
            "fax_number": "347-506-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14809 NORTHERN BLVD STE 1K",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544308",
            "telephone_number": "347-506-0325",
            "fax_number": "347-506-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "DOYOUNG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-506-0325",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.practicesuite.com",
            "affiliation": "N",
            "address_1": "14809 Northern Blvd Ste 1K",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113544308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.