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

Michelle Park

Individual provider Specialist · NPI 1811721434

Michelle Park is a Specialist in Bayside, New York. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

21510 Northern Blvd Ste 202
Bayside, NY 11361-3497
Phone: (718) 631-1034
Show map & directions

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

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1811721434
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 27, 2024
Last updated in NPPESAugust 29, 2024
Certification dateAugust 29, 2024
Mailing address21410 15th Ave Apt 2e, Bayside, NY 11360-2217

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