DAVID JUNEWON PARK (NPI# 1972000677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972000677 |
| Entity Type | Individual |
| Full Name | DAVID JUNEWON PARK |
| Credential | PA-C |
| Practice Address |
1825 Eastchester Rd Bronx NY 10461-2301 |
| Mailing Address |
5235 Buford Hwy Ne Doraville GA 30340-1106 |
| Practice Telephone | 7189042000 |
| Mailing Telephone | 4047179051 |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2020-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 8743 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 1140276 | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
024237 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GEORGIA PA LICENSE NUMBER | 8743 | 01 |
| NCCPA PA LICENSE NUMBER | 1140276 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524743 | David Park | Dentist | 810 3rd Ave Ste 200, Seattle, WA 98104-1614 | 2020-09-27 |
| 1447879648 | David Jaehyun Park | Student in an Organized Health Care Education/Training Program | 193 Oak St Apt 202e, Newton Upper Falls, MA 02464-1449 | 2020-04-09 |
| 1093363574 | David Mansug Park | Acupuncturist | 5200 Newberry Rd Ste D8, Gainesville, FL 32607-2177 | 2019-08-28 |
| 1831614387 | David Ji Hyun Park | Dentist | 393 Dunlap St N Ste 308, Saint Paul, MN 55104-4223 | 2017-08-06 |
| 1265686448 | David H Park | Dentist | 3530 Dartmouth Ln, Rowland Heights, CA 91748-5135 | 2008-11-14 |
| 1578763413 | David Kyung-il Park | Emergency Medicine | 2500 Merced Sreet, San Leandro, CA 94577-4201 | 2007-07-19 |
| 1942410501 | David S Park | Dentist | 10390 Coloma Rd Ste A, Rancho Cordova, CA 95670-2152 | 2007-05-23 |
| 1780762245 | David Hwantae Park | Optometrist | 7750 N Macarthur Blvd, Ste 180, Irving, TX 75063-7524 | 2006-11-01 |
| 1942315874 | David Daegeun Park | Family Medicine | 119 S Fuquay Avenue, Fuquay-varina, NC 27526-2210 | 2006-08-20 |
| 1114558897 | David Seho Park | Pharmacist | 25825 Vermont Ave, Harbor City, CA 90710-3518 | 2020-01-30 |
| Street Address |
1825 EASTCHESTER RD |
| City | BRONX |
| State | NY |
| Zip Code | 10461-2301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952307076 | Michael Levgur | Specialist | 1825 Eastchester Rd, Bronx, NY 10461-2301 | 2005-06-23 |
| 1871192252 | Kristy Cecile Beauharnais | Internal Medicine | 1825 Eastchester Rd, Bronx, NY 10461-2301 | 2020-10-18 |
| 1629683982 | Alaina Myers | Physician Assistant | 1825 Eastchester Rd, Bronx, NY 10461-2301 | 2020-09-14 |
| 1104430404 | Gerard Joseph Cioffi | Physician Assistant | 1825 Eastchester Rd, Bronx, NY 10461-2301 | 2020-09-03 |
| 1376156026 | Jose Antonio Fernandez | Occupational Therapist | 1825 Eastchester Rd, Bronx, NY 10461-2301 | 2020-08-24 |
| 1861018046 | Victoria Ashleigh Veres | Physician Assistant | 1825 Eastchester Rd, Bronx, NY 10461-2301 | 2020-06-23 |
| 1720602055 | Valerie L Orourke | Physician Assistant | 1825 Eastchester Rd, Bronx, NY 10461-2301 | 2020-06-02 |
| 1245852003 | Zelalem Tadesse Argaw | Registered Nurse | 1825 Eastchester Rd, Bronx, NY 10461-2301 | 2020-05-14 |
| 1508493636 | Arlin Idikula | Physician Assistant | 1825 Eastchester Rd, Bronx, NY 10461-2301 | 2020-03-26 |
| 1699309542 | Yael Lazarus | Physician Assistant | 1825 Eastchester Rd, Bronx, NY 10461-2301 | 2020-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427665975 | Zhanna Kleynerman | Pharmacist | R&a Drugs Inc, 2562 Est Tremont Ave, Bronx, NY 10461 | 2020-09-29 |
| 1245867738 | Dalia Duzdar | Student in an Organized Health Care Education/Training Program | 1400 Pelham Pkwy S Building 6, Suite B125, Bronx, NY 10461 | 2020-03-24 |
| 1306486667 | Alvin Antony Mathew | Physical Therapist | 1500 Blondell Ave., Bronx, NY 10461 | 2020-01-14 |
| 1295374007 | Felicia Bowman | Peer Specialist | 55 Westchester Square Bronx, 55 Westchester Square Bronx, Bronx, NY 10461 | 2019-12-26 |
| 1477191161 | Todd Benevento Jr. | Physical Therapist | 1250 Waters Place Tower One 10th Floor, Bronx, NY 10461 | 2019-12-13 |
| 1073173845 | Harriet Sarpong-blankson | Pharmacist | Jack D Weiler Hospital, 1825 Eastchester Road, Bronx, NY 10461 | 2019-06-14 |
| 1396300166 | Victoria Sliva | Psychologist | 1400 Pelham Pkwy S Bldg 19w, Bldg 1, 9w, Bronx, NY 10461 | 2019-05-07 |
| 1538723366 | Shuai Wang | Student in an Organized Health Care Education/Training Program | 1400 Pelham Parkway South Jacobi Medical Center, Bronx, NY 10461 | 2019-04-26 |
| 1457810079 | Morpheus Sleep Solutions Inc | Durable Medical Equipment & Medical Supplies | 3004 Middletown Road, Lower Level Unit 1, Bronx, NY 10461 | 2019-03-13 |
| 1922565118 | Metro Care Management LLC | Case Management | 2481 Rowe St, Bronx, NY 10461 | 2019-02-25 |
| Find all providers in zip 10461 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568006682 | Walces Castelly | Physician Assistant | 860 Grand Concourse Apt 1l, Bronx, NY 10451-2815 | 2019-10-31 |
| 1447815949 | Shadman Emrose Noshin | Physician Assistant | 2843 Dudley Ave Fl 2, Bronx, NY 10461-5609 | 2019-05-09 |
| 1275024952 | Barbara Hoffman | Physician Assistant | 1017 Burke Ave, Bronx, NY 10469-3803 | 2018-05-29 |
| 1154791473 | Edelmys Suncar | Physician Assistant | 1150 Webster Ave, Bronx, NY 10456-5205 | 2015-09-29 |
| 1083096697 | Victoria Owusuaa | Physician Assistant | 2334 Tiebout Ave, Apt # 4e, Bronx, NY 10458-7310 | 2015-06-19 |
| 1093102865 | Rlb Alternative Care Inc | Physician Assistant | 574 E 170th St, C/o Ricardo L. Baez, Bronx, NY 10456-2304 | 2015-04-20 |
| 1235532078 | Ethan Searles | Physician Assistant | 91 Poplar Ave, Bronx, NY 10465-3943 | 2014-10-08 |
| 1053713164 | Pranvera Dervishi | Physician Assistant | 1334 Astor Ave, Pvh 2nd Floor, Bronx, NY 10469-5832 | 2014-09-19 |
| 1588934814 | Melinda Jimenez | Physician Assistant | 2306 Walton Ave, Bronx, NY 10468-7102 | 2012-01-03 |
| 1194094300 | Ayisha Munawar | Physician Assistant | 285 E 171st St, Bronx, NY 10457-8939 | 2011-12-16 |
| Find all providers in BRONX | ||||
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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.