Individual provider Active NPI

Doweon Park, L.AC

  • Acupuncturist
  • Syosset, NY
National Provider Identifier
1487934519
Registry record updated Aug 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
4639 Issued in NY
Practice address
38 Willets Dr
Syosset, NY 11791-3917
Phone
(516) 506-3362
NPI assigned
Aug 20, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 4639 NY Primary

Addresses

Primary practice location

38 Willets Dr
Syosset, NY 11791-3917

Mailing address

38 Willets Dr
Syosset, NY 11791-3917
Phone (516) 506-3362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4639NYMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1313798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313798400000",
    "number": "1487934519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 WILLETS DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913917",
            "telephone_number": "516-506-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 WILLETS DR",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913917",
            "telephone_number": "516-506-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "DOWEON",
        "name_prefix": "Mr.",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-20",
        "last_updated": "2011-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "4639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2011; 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.