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Jea Young Park
Student in an Organized Health Care Education/Training Program in Derby, Connecticut
NPI 1831752864

Jea Young Park is a Student in an Organized Health Care Education/Training Program based in Derby, CT. Jea Young Park practices in Derby, CT. The NPI Number for Jea Young Park is 1831752864 and holds a License No. (Connecticut).

The current practice location address for Jea Young Park is 130 Division St, Derby, CT and can be reached out via phone at 203-732-7327.

Location: 130 Division St, Derby, CT, 06418-1326
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1831752864
Provider Name
Jea Young Park
Credential
Provider Entity Type
Individual
Gender
Male
Address
130 Division St, Derby, CT, 06418-1326
Phone Number
203-732-7327
Fax Number
Provider Enumeration Date
04/16/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
130 Division St
City
Derby
State
Connecticut
Zip
06418-1326
Phone Number
203-732-7327
Fax Number
person
Provider Business Mailing Address Details
Address
130 Division St
City
Derby
State
Connecticut
Zip
06418-1326
Phone Number
203-732-7327
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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