Provider Demographics
NPI:1528243813
Name:PARK, HANG KYU (MD)
Entity type:Individual
Prefix:
First Name:HANG
Middle Name:KYU
Last Name:PARK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8424
Mailing Address - Street 2:INSURANCE CREDENTIALING
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-0424
Mailing Address - Country:US
Mailing Address - Phone:845-223-8080
Mailing Address - Fax:845-223-8081
Practice Address - Street 1:942 ROUTE 376 STE 16
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6484
Practice Address - Country:US
Practice Address - Phone:845-232-8080
Practice Address - Fax:845-223-8081
Is Sole Proprietor?:No
Enumeration Date:2008-01-04
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine