Sang Jun Park, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

25 004315 Issued in NY

Practice address

136-18 35TH Ave
#18
Flushing, NY 11354

Phone

(917) 687-8121

NPI assigned

May 1, 2013

Sex

Male

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

State licenses

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1831534106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3933 47TH ST",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "111041419",
            "telephone_number": "917-687-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136-18 35TH AVE",
            "address_2": "#18",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11354",
            "telephone_number": "917-687-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SANG JUN",
        "name_prefix": "Mr.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "25 004315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• No Tae Park
• Olivia Park, PHARMD
• Rana Park
• Sae-Lyoung Park, D.P.M.
• Sang Ho Park, D.C.
• So-Youn Park
• Sojeung Park, PHARMD
• Soyul Park
• Soyun Park
• Sungkuk Park, M.S., CCC-SLP

• Acupuncturist in Flushing, NY
• Providers in Flushing, NY by specialty
• Acupuncturist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; 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.