Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jaehyoung Park

Individual provider Physician Assistant · NPI 1578220638

Jaehyoung Park is a Physician Assistant in Flushing, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

14647 27th Ave
Flushing, NY 11354-1427
Phone: (347) 371-2103
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 030454 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1578220638
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 23, 2021
Last updated in NPPESDecember 8, 2023
Certification dateDecember 8, 2023
Mailing address14647 27th Ave, Flushing, NY 11354-1427

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