| Doctor Name: | MR. EUNG WHAN PARK |
| NPI Number: | 1124263330 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 115322 |
| Business Practice Address: | 15 Copperleaf Terrace Staten Island Ny, NY - 10304 |
| Business Phone Number: | 7189876652 |
| Business Fax Number: | 7189876652 |
| Mailing Address: | 15 Copperleaf Terrace, STATEN ISLAND |
| State: | NY |
| Postal Code: | 10304 |
| Phone Number: | 7189876652 |
| Fax Number: | 7189876652 |
| NPI Enumeration Date: | 12/03/2008 |
| NPI Last Update Date: | 12/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 115322 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |