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Organization
UNITED MEDICAL PC
Active
Organization
UNITED MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BYONG PARK M.D. (PRESIDENT)
(201) 460-0063
Entity
Organization
Contact information
Practice address
612 RUTHERFORD AVE, LYNDHURST, NJ 07071-1217
(201) 460-0063
(201) 460-1684
Mailing address
612 RUTHERFORD AVE, LYNDHURST, NJ 07071-1217
(201) 460-0063
(201) 460-1684
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
933910
NJ
207Q00000X
Family Medicine Physician
25MA0352770
NJ
207QG0300X
Geriatric Medicine (Family Medicine) Physician
25MA08490600
NJ
207R00000X
Internal Medicine Physician
Primary
25MA04562300
NJ
207RC0000X
Cardiovascular Disease Physician
25MA09171800
NJ
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
25MA08599900
NJ
207RG0100X
Gastroenterology Physician
MA062232
NJ
207RN0300X
Nephrology Physician
25MA0497600
NJ
207V00000X
Obstetrics & Gynecology Physician
25MA05208400
NJ
207W00000X
Ophthalmology Physician
25MA063700000
NJ
208100000X
Physical Medicine & Rehabilitation Physician
25MA08540700
NJ
2085R0204X
Vascular & Interventional Radiology Physician
MA048966
NJ
363LA2200X
Adult Health Nurse Practitioner
26NJ00326000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0174653
—
NJ
05
—
0251623
—
NJ
05
—
1163604
—
NJ
01
—
25MA07920500
MD LICENSE
NJ
01
—
25MD00232400
DPM LICENSE
NJ
01
—
26NJ00326000
ADVANCED NURSE PRACTITIONER
NJ
05
—
7027508
—
NJ
05
—
7326505
—
NJ
05
—
7930101
—
NJ
01
—
978514
CERTIFICATE AMERICAN DIETETIC ASSOCIATION
—
Enumeration date
06/03/2006
Last updated
02/11/2014
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