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

Justina Park

Individual provider Acute Care Nurse Practitioner · NPI 1033090345

Justina Park is a Nurse Practitioner in New York, New York. Qualified in 2025, 1 year ago. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2025

Practice location Address checks out

622 W 168th St
New York, NY 10032-3720
Phone: (212) 305-4550
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 433409 (NY)

Record details

NPI number1033090345
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 11, 2025
Last updated in NPPESSeptember 11, 2025
Certification dateSeptember 11, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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