DR. JIA PARK (NPI# 1588774921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588774921 |
| Entity Type | Individual |
| Full Name | DR. JIA PARK |
| Credential | M.D |
| Practice Address |
210-08 35th Avenue Bayside NY 11361-2979 |
| Practice Telephone | 7182294090 |
| Practice Fax Number | 7182244131 |
| Mailing Telephone | 7182294090 |
| Mailing Fax Number | 7182244131 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-02-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 214047 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02180216 | 05 |
| Street Address |
210-08 35TH AVENUE |
| City | BAYSIDE |
| State | NY |
| Zip Code | 11361-2979 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467078055 | Nicole E. Sarracco | Speech-Language Pathologist | 215 - 46 39th Avenue, Flushing, NY 11361 | 2020-06-19 |
| 1689294381 | Terri Robin Will | Registered Nurse | 3416 2019th Street, Queens, NY 11361 | 2020-04-22 |
| 1295364875 | Melanie Besthoff | Speech-Language Pathologist | 215-46 39th Avenue, Flushing, NY 11361 | 2020-04-05 |
| 1790339844 | Alana Valle | Occupational Therapist | 20947 34th Rd, Bayside, NY 11361 | 2019-07-26 |
| 1881175826 | Eva Mui | Pharmacist | 212 Northern Blvd, Bayside, NY 11361 | 2018-08-28 |
| 1063908531 | Hongik Acupuncture N.y. P.C. | Acupuncturist | 21441 42nd Ave Ste 4c, Bayside, NY 11361 | 2018-07-07 |
| 1093233694 | Karen Trentacosta | Registered Nurse | 40-04a Bell Boulevard, Bayside, NY 11361 | 2017-09-03 |
| 1801310131 | Hee Gi An | Dentist | 42-05 204th St, Flr 2, Bayside, NY 11361 | 2017-07-28 |
| 1780113050 | Miaoying Zhu | Social Worker | 217-63 Corbett Rd, Bayside, NY 11361 | 2017-06-08 |
| 1679016265 | Daniela Ragusa | Speech-Language Pathologist | 221-21 Corbett Road, Bayside, NY 11361 | 2016-11-30 |
| Find all providers in zip 11361 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417344243 | Liana Magdalena Wright | Family Medicine | 21462 33rd Ave, Bayside, NY 11361-1627 | 2015-04-20 |
| 1760726707 | John Edward Deloria | Family Medicine | 3835 204th St, Bayside, NY 11361 | 2012-11-15 |
| 1821391152 | Jaime J Villaruz | Family Medicine | 3839 Bell Blvd Ste 233, Bayside, NY 11361-2029 | 2010-12-08 |
| 1902092067 | Alan S Green | Family Medicine | 2805 202nd St, Bayside, NY 11360-2326 | 2007-09-21 |
| 1790995249 | Dr. Timothy Robinson, General and Family Medicine, P.C. | Family Medicine | 3245 Bell Blvd, Bayside, NY 11361-1060 | 2007-05-23 |
| 1528196300 | Steven Bernhard | Family Medicine | 3921 Bell Blvd, Bayside, NY 11361-2096 | 2007-03-01 |
| 1912050915 | Robert Harold Straub | Family Medicine | 9480 N Broadmoor Rd, Bayside, WI 53217-1309 | 2007-01-21 |
| 1417017443 | First Med Immediate Medical Services of Queens PC | Family Medicine | 21021 Northern Blvd, Bayside, NY 11361 | 2006-12-11 |
| 1275611527 | Saul Maslavi Md PC | Family Medicine | 4232 Francis Lewis Blvd, 1st Floor, Bayside, NY 11361-2561 | 2006-11-02 |
| 1689754582 | Timothy Thomas Robinson | Family Medicine | 32-45 Bell Blvd, Bayside, NY 11361 | 2006-10-16 |
| Find all providers in BAYSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.