MYUNG PARK (NPI# 1710342472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710342472 |
| Entity Type | Individual |
| Full Name | MYUNG PARK |
| Practice Address |
3050 White Plains Road Bronx NY 10467 |
| Mailing Address |
3050 White Plains Rd Bronx NY 10467-8124 |
| Practice Telephone | 7189447115 |
| Practice Fax Number | 7189447091 |
| Mailing Telephone | 7189447115 |
| Mailing Fax Number | 7189447091 |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2015-12-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205875986 | Myung Hee Park | Internal Medicine | 1802 Yakima Ave Ste 302, Tacoma, WA 98405-5305 | 2006-06-06 |
| 1134527047 | Myung Park | Dentist | 7770 Sightseeing Rd, Dencom, Fort Benning, GA 31905-3764 | 2014-12-09 |
| 1699031633 | Myung N Park I | Massage Therapist | 5006 Center St, Suite #d, Tacoma, WA 98409-2314 | 2012-04-04 |
| 1831425545 | Myung Kyu Park | Acupuncturist | 4671 Express Dr N, Ronkonkoma, NY 11779-5562 | 2009-10-30 |
| 1639389679 | Myung S Park | Surgery | 200 1st St Sw, Rochester, MN 55905 | 2007-05-22 |
| 1093753162 | Myung Park | Pediatrics | 3533 S Alameda St, Corpus Christi, TX 78411-1721 | 2006-06-02 |
| Street Address |
3050 WHITE PLAINS ROAD |
| City | BRONX |
| State | NY |
| Zip Code | 10467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245354083 | Isabella Kanellopoulou | Psychiatry & Neurology | 3050 White Plains Road, Bronx, NY 10467 | 2007-03-19 |
| 1417571639 | Samaritan Daytop Village, Inc. | Clinic/Center | 3050 White Plains Road, Bronx, NY 10467 | 2020-06-03 |
| 1790140341 | Ian Dacosta | Counselor | 3050 White Plains Road, Bronx, NY 10469 | 2015-12-28 |
| 1629433388 | Henry Perez | Counselor | 3050 White Plains Road, Bronx, NY 10467 | 2015-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535505 | Maxwell Ennist | Massage Therapist | 210 Bedford Park Blvd, Bronx, NY 10467 | 2020-10-09 |
| 1144854431 | Ny Metro Dental, PC | Dentist | 55 Mosholu Parkway North, Bronx, NY 10467 | 2020-02-26 |
| 1386277960 | Rhonda Ellen Nayberg | Occupational Therapist | Montefiore Medical Center Occupational Therapy Dept, 111 E 210 Street Ground Floor Blue Zone, Bronx, NY 10467 | 2020-02-21 |
| 1013568153 | Jaime Luis Betancourt | Nurse Practitioner | Sickle Cell Clinic, 3400 Bainbridge Avenue, Bronx, NY 10467 | 2019-09-20 |
| 1023662616 | Bronx Jewish Community Council Home Attendant Services | Home Health | 2930 Wallace Ave., Bronx, NY 10467 | 2019-07-31 |
| 1831755321 | Felix Medrano | Taxi | 3106 Webster Ave, Bronx, NY 10467 | 2019-05-10 |
| 1700363108 | Danaies Guzman | Occupational Therapist | 2410 Barker Avenue Apt 11a, Bronx, New York, NY 10467 | 2018-07-27 |
| 1538672175 | Carolina Duque-toro | Speech-Language Pathologist | 4251, 341 E 207th St, Bronx, NY 10467 | 2017-11-06 |
| 1255853727 | Jessica Perkiss | Social Worker | 750 Tilden St., Astor Services for Children and Families, Bronx, NY 10467 | 2017-07-17 |
| 1386166221 | Erica Santos | Licensed Practical Nurse | 3273 Parkside Place, Apt 5g, Bronx, NY 10467 | 2017-07-12 |
| Find all providers in zip 10467 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295374007 | Felicia Bowman | Peer Specialist | 55 Westchester Square Bronx, 55 Westchester Square Bronx, Bronx, NY 10461 | 2019-12-26 |
| 1750743639 | Jean Edouard | Peer Specialist | 640 W 232nd St, Bronx, NY 10463-3207 | 2016-03-22 |
| 1528565108 | Ramona Katiusca Santiago | Peer Specialist | 560 Southern Blvd, Bronx, NY 10455-3715 | 2018-04-10 |
| 1043751951 | Patricia Strauchn | Peer Specialist | 640 W 232nd St, Bronx, NY 10463-3207 | 2017-03-10 |
| 1568906683 | Jacqueline Belardo | Peer Specialist | 1910 Arthur Ave, 8th Floor #21, Bronx, NY 10457 | 2016-12-08 |
| 1427503531 | Margarita Perez | Peer Specialist | 1423 Prospect Ave, Bronx, NY 10459-1208 | 2016-08-18 |
| 1205288800 | Mark Rabb | Peer Specialist | 522 Courtlandt Ave, Bronx, NY 10451-5008 | 2016-07-07 |
| 1831540194 | Tameeka Gregg | Peer Specialist | 1500 Waters Pl, Bronx, NY 10461-2723 | 2016-06-28 |
| 1619337011 | Olivia Michelle Johntry | Peer Specialist | 1500 Waters Pl, Bronx, NY 10461-2723 | 2016-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385896 | Gary N/a Peluso | Peer Specialist | 62 Allan Dr, East Norwich, NY 11732-1203 | 2020-10-28 |
| 1043810138 | Ryan Hope Mcgovern | Peer Specialist | 950 S Oyster Bay Rd Bay Road, Hicksville, NY 11801-3510 | 2020-10-28 |
| 1669070207 | Sayeeda Zorita Daniels | Peer Specialist | 111 Woodlawn Ave Apt 2, Buffalo, NY 14209-1713 | 2020-10-15 |
| 1801409842 | Alexander Mannino | Peer Specialist | 419 Palisade Ave, Yonkers, NY 10703-2610 | 2020-08-28 |
| 1053924522 | Graham Joshua Anderson | Peer Specialist | 64 Linwood Ave., Buffalo, NY 14209 | 2020-08-25 |
| 1467064832 | Kenneth Robert Lewis | Peer Specialist | 320 N Goodman St Ste 202320, Rochester, NY 14607-1185 | 2020-08-18 |
| 1700404001 | Kathy Annett Gardini | Peer Specialist | 1914 Brookhaven Ave, Far Rockaway, NY 11691-3626 | 2020-07-13 |
| 1669099826 | Moseka Turkessa James | Peer Specialist | 1220 Remsen Ave # 1, Brooklyn, NY 11236-3925 | 2020-07-02 |
| 1174140545 | Mercedes Busby | Peer Specialist | 118 Brauncroft Ln, Amherst, NY 14226-4957 | 2020-07-01 |
| 1457977258 | Carla J Alomar | Peer Specialist | 414 Martin Rd, Lackawanna, NY 14218-2830 | 2020-06-18 |
| Find all providers with the same taxonomy | ||||
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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.