Mija Park, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F359461 Issued in NY

Practice address

4124 50TH St Apt 6E
Woodside, NY 11377-4318

Phone

(347) 777-6130

NPI assigned

Jun 2, 2026

Last updated

Jun 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1780358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1396677407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4124 50TH ST APT 6E",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774318",
            "telephone_number": "347-777-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4124 50TH ST APT 6E",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113774318",
            "telephone_number": "347-777-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MIJA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F359461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kleomenis D Paraskevas, MD
• Anfernee Cel Calonia Paredes, RPT
• Nived Nishith Parikh
• Bum Y Park, M.D.
• Jay Eun Park
• Sung Park, DMD
• Angela Patricia Parra, DPT
• Partners in Aging, LLC
• Christina Parvin, PHARM. D
• Ami Patel, R.PH.

• Family Nurse Practitioner in Woodside, NY
• Providers in Woodside, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.