Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
YONGTACK PARK
Deactivated Sole ProprietorYONGTACK PARK is a Physical Therapy Assistant healthcare provider located in FORT LEE, New Jersey. NPI 1144576331 is deactivated in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · FORT LEE, NJ
This NPI has been deactivated.
The record was deactivated on February 19, 2013.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1144576331
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 25, 2012 (0.57260273972603 yrs)
- Last Updated
- Nov 8, 2022
- Deactivated
- Feb 19, 2013
- License
-
017697 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
800 PALISADE AVENUE#308FORT LEE, NJ, 07024Browse NJ providers · Browse ZIP 07024
- Phone
- 3473346860
- Fax
- 3476028662
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in FORT LEE, NJ
| Name | Credential | NPI |
|---|---|---|
| MRS. ROBERTA DIANE GEISENHEIMER | P.T. | 1407823883 |
| SANG-UK LEE | P.T | 1992817852 |
| SUNG BAM WEE | PT | 1467552182 |
| MISS GINA OTILIA HEREDEA | P.T. | 1003984451 |
| JENNIFER SCHAEFER HEPSEN | D.P.T. | 1073676441 |
| GARY FLINK | M.S.P.T. | 1063575488 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.