DR. SAE JOUN PARK (NPI# 1720045313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720045313 |
| Entity Type | Individual |
| Full Name | DR. SAE JOUN PARK |
| Credential | M.D. |
| Practice Address |
10 Mitchell Ave Binghamton NY 13903-1617 |
| Practice Telephone | 6077622020 |
| Practice Fax Number | 6077622029 |
| Mailing Telephone | 6077622020 |
| Mailing Fax Number | 6077622029 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2010-03-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 110896 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | EXCELLUS BC & BS | BPSJ393 | 01 |
| NY | 00395675 | 05 | |
| NY | GHI | 0083157 | 01 |
| NY | MVP | 088125 | 01 |
| Street Address |
10 MITCHELL AVE |
| City | BINGHAMTON |
| State | NY |
| Zip Code | 13903-1617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861830812 | Trisha Chambers | Social Worker | 10 Mitchell Ave, New Horizons, Binghamton, NY 13903 | 2013-06-12 |
| 1871833798 | Caitlyn Ann Lewis | Counselor | 10 Mitchell Ave, New Horizons, Binghamton, NY 13903 | 2013-03-01 |
| 1558685891 | Stacy Lynn Feltz | Pharmacist | 10 Mitchell Ave, Binghamton, NY 13903-1617 | 2010-03-16 |
| 1316260045 | Sae Joun Park PC | Family Medicine | 10 Mitchell Ave, Binghamton, NY 13903-1617 | 2010-03-09 |
| 1568697803 | Sarah L Smith | Social Worker | 10 Mitchell Ave, Binghamton, NY 13903-1617 | 2009-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982241121 | Diane Irene Davie | Specialist | 37 1/2 Hayes St, Binghamton, NY 13903 | 2019-12-06 |
| 1801440375 | Jonathan James Pelc | Pharmacist | 50 Pennsylvania Avenue, Binghamton, NY 13903 | 2019-08-01 |
| 1265815211 | Miriam Mikaya | Nurse Practitioner | 10-42 Mitchel Avenue, Binghamton, NY 13903 | 2015-07-08 |
| 1538541925 | Marianne Valenzuela | Nurse Practitioner | 27 Park Avenue, 5th Floor, Binghamton, NY 13903 | 2015-06-23 |
| 1962884379 | Norman Dale Powell Sr. | Nurse's Aide | 43 Webster St., Apt. 2, Binghamton, NY 13903 | 2015-06-22 |
| 1659612562 | Helena Maureen Ladue | Counselor | 10 Mitchell Avenue, New Horizons, Binghamton, NY 13903 | 2013-03-04 |
| 1144597527 | Allan M. Fernandez | Family Medicine | 35 Felters Road, Building 8, Binghamton, NY 13903 | 2011-11-29 |
| 1386875482 | Earle John Reome | Pharmacist | 10-34 Mitchell Avenue, Binghamton, NY 13903 | 2009-08-06 |
| 1619113149 | Teresa Mae Grant | Massage Therapist | 20 Mitchell Avenue, Binghamton, NY 13903 | 2009-01-06 |
| 1932383791 | Diane Lucille Brenner | Licensed Practical Nurse | 60 Saratoga Ave, 5 20, Binghamton, NY 13903 | 2007-12-28 |
| Find all providers in zip 13903 | ||||
| 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 |
|---|---|---|---|---|
| 1508343450 | Michael Patrick Reistetter | Family Medicine | 17 Chenango Bridge Rd., Binghamton, NY 13901 | 2018-07-24 |
| 1144597527 | Allan M. Fernandez | Family Medicine | 35 Felters Road, Building 8, Binghamton, NY 13903 | 2011-11-29 |
| 1881914067 | Michelle Andre Teves | Family Medicine | 58 Grand Blvd, Binghamton, NY 13905-3353 | 2010-06-10 |
| 1083881411 | Vasilios Tzoumas | Family Medicine | 160 Robinson St, Binghamton, NY 13904-1842 | 2008-05-14 |
| 1851420566 | Aristaks Kachadourian | Family Medicine | 137 Riverside Drive, Binghamton, NY 13905-4217 | 2007-03-06 |
| 1396806295 | John J. Zygmunt | Family Medicine | Route 434 Vestal Parkway, Binghamton, NY 13902-6000 | 2006-12-13 |
| 1861564999 | Sanjiv A Patel | Family Medicine | 1130 Upper Front St, Binghamton, NY 13905-1118 | 2006-11-14 |
| 1376625897 | Michael Edward Leonard | Family Medicine | 4400 Vestal Parkway East, Binghamton University Health Service, Binghamton, NY 13902-6000 | 2006-10-20 |
| 1912993460 | Timothy S Roche | Family Medicine | 142 Clinton St, Clinton Street Family Care Center, Binghamton, NY 13905-2212 | 2005-09-21 |
| 1477546141 | John Curtis Prindle | Family Medicine | 26 S. Washington Street, Binghamton, NY 13903 | 2005-08-26 |
| Find all providers in BINGHAMTON | ||||
| City | BINGHAMTON |
| Zip Code | 13903 |
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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.