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

SE Jong Park, CSTAS-C

Individual provider Surgical Assistant · NPI 1962671545

SE Jong Park, CSTAS-C is a Surgical Assistant in Portland, Maine. Practices as a sole proprietor. Licensed in Maine.

Licensed in
ME
In the registry since
2008

Practice location Address checks out

51 Illsley St
Portland, ME 04103-5110
Phone: (207) 756-3621
Fax: (888) 329-6432
Show map & directions

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

Specialties & licences

Surgical Assistant (primary) Taxonomy 246ZC0007X (ME)

Record details

NPI number1962671545
Entity typeIndividual (Type 1)
GenderFemale
Credentials CSTAS-C
Sole proprietorYes
NPI enumeratedFebruary 27, 2008
Last updated in NPPESFebruary 27, 2008
Mailing address51 Illsley St, Portland, ME 04103-5110

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