| Organization Name: | HONG SIK PAK MD COREA REHAB PAIN CLINIC |
| NPI Number: | 1104210632 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN KIM (BILLER) |
| Mailing Address: | 725 Grand Ave Suite 103 Ridgefield |
| State: | NJ US |
| Postal Code: | 076571045 |
| Phone Number: | 2014466701 |
| Fax Number: | 2018407008 |
| NPI Enumeration Date: | 03/23/2015 |
| NPI Last Update Date: | 03/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225400000X |
| License Number: | 25MA07185900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Rehabilitation Practitioner |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |