Active NPI
Yu Kyong Park
- Physical Therapist
- Flushing, NY
National Provider Identifier
1528423746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 035075
- Practice address
- 15301 Northern Blvd
#2G
Flushing, NY 11354-5035 - Phone
- (718) 888-1641
- NPI assigned
- Dec 15, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 035075 | NY | Primary |
Addresses
Primary practice location
15301 Northern Blvd
#2G
Flushing, NY 11354-5035
Mailing address
15301 Northern Blvd
#2G
Flushing, NY 11354-5035
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
| License | State | Type | Specialty |
|---|---|---|---|
| 035075 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450137600000",
"number": "1528423746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15301 NORTHERN BLVD",
"address_2": "#2G",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113545035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15301 NORTHERN BLVD",
"address_2": "#2G",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113545035",
"telephone_number": "718-888-1641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "YU KYONG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-15",
"last_updated": "2015-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "035075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.