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

Jung Ryeol Park, RPT

Individual provider Physical Therapist · NPI 1679742274

Jung Ryeol Park, RPT is a Physical Therapist in Private Practice in Bayside, New York. Qualified in 1999, 27 years ago. Accepts Medicare assignment. Licensed in New York.

Years since qualifying
27
Licensed in
NY
In the registry since
2008
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Practice location Address checks out

21915A Northern Blvd
Bayside, NY 11361-3525
Phone: (718) 423-3400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 023674 (NY)

Record details

NPI number1679742274
Entity typeIndividual (Type 1)
GenderMale
Credentials RPT
Sole proprietorNo
NPI enumeratedFebruary 27, 2008
Last updated in NPPESSeptember 5, 2023
Certification dateSeptember 5, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bayside