IndividualActive
Se Jong Park, CST AS-C
NPI 1962671545 · Surgical Assistant · Portland, ME
Provider details
- NPI number
- 1962671545
- Entity type
- Individual
- Primary specialty
- Surgical AssistantTechnologists, Technicians & Other Technical Service Providers
- Credential
- CST AS-C
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
51 Illsley St
Portland, ME 04103-5110
Phone: (207) 756-3621
Fax: (888) 329-6432
Approximate (ZIP-level) locationGet directions
Mailing address
51 Illsley St
Portland, ME 04103-5110
Registry dates
- Enumerated
- 2008-02-27
- Last updated
- 2008-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.