NPI 1962671545

SE Jong Park, CSTASC

Practitioner Surgical Assistant Portland, ME

Practice location

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

Registered specialties

Surgical Assistant Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZC0007X

Other Specialist/Technologist, Other providers in Maine →

Registry record

NPI: 1962671545
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Feb 2008
Record last updated: 27 Feb 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.