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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1649037888

Jiyeon Park, MD is a Student in an Organized Health Care Education/Training Program in Stony Brook, New York. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

101 Nicolls Rd Rm 40
Stony Brook, NY 11794-8093
Phone: (631) 444-1916
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1649037888
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 4, 2024
Last updated in NPPESMarch 4, 2024
Certification dateFebruary 28, 2024

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