Provider Demographics
NPI:1760576029
Name:OH-PARK, MOO-YEON (MD)
Entity Type:Individual
Prefix:
First Name:MOO-YEON
Middle Name:
Last Name:OH-PARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 MAMARONECK AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2523
Mailing Address - Country:US
Mailing Address - Phone:914-597-2562
Mailing Address - Fax:914-597-2588
Practice Address - Street 1:785 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2523
Practice Address - Country:US
Practice Address - Phone:914-597-2562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204885208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation