Samuel Park MD, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SAMUEL PARK MD, PLLC

Practice address

160 1St St Unit 551
Mineola, NY 11501-5025

Phone

(516) 619-8098

NPI assigned

Sep 26, 2016

Organization subpart

No

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

Authorized official

Name

Samuel J Park, MD

Title

President

Phone

(516) 619-8098

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1225587793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 1ST ST UNIT 551",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115015025",
            "telephone_number": "516-619-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 1ST ST UNIT 551",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115015025",
            "telephone_number": "516-619-8098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL PARK MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-26",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-619-8098",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Salner, O.D.
• Hamzah Sami, DO
• Judith Lynne Sampson-Chimon, RD
• Gil Samson, M.D.
• Samuel Kenan,MD.,P.C
• Jeffrey T Samuel, DO
• Shady Samuel
• Sonam Sani, M.D.
• Allen Sankovich, RPH
• Natalie Santana, MD

• Internal Medicine Physician in Mineola, NY
• Providers in Mineola, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; 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.