Provider Demographics
NPI:1770024515
Name:PARK-CHONG, HELEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:
Last Name:PARK-CHONG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HAEBITNA
Other - Middle Name:
Other - Last Name:CHONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:NEW YORK PRESBYTERIAN-COLUMBIA UNIVERSITY MEDICAL CENTE
Mailing Address - Street 2:622 W 168TH STREET, VC #205
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:866-463-2778
Mailing Address - Fax:212-342-6011
Practice Address - Street 1:NEW YORK PRESBYTERIAN-COLUMBIA UNIVERSITY MEDICAL CENTE
Practice Address - Street 2:622 W 168TH STREET, VC #205
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:866-463-2778
Practice Address - Fax:212-342-6011
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340090207Q00000X, 363LF0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4736816Medicaid