Provider Demographics
NPI:1336509223
Name:PARK, HYOJIN
Entity Type:Individual
Prefix:MS
First Name:HYOJIN
Middle Name:
Last Name:PARK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 HULME COURT, APT 107
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305
Mailing Address - Country:US
Mailing Address - Phone:650-556-3404
Mailing Address - Fax:
Practice Address - Street 1:935 GARFIELD AVENUE
Practice Address - Street 2:METROPOLITAN FAMILY HEALTH NETWORK, INC. - JERSEY CITY
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304
Practice Address - Country:US
Practice Address - Phone:201-478-5807
Practice Address - Fax:201-478-5838
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program