# LISA PARK, M.D. PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780871947
- **Authorized official:** DR. LISA PARK M.D. (SOLE OWNER)
- **Authorized official phone:** (212) 263-2573

## Contact information

- **Practice address:** 530 1ST AVE, HCC SUITE 3B, NEW YORK, NY 10016-6402
- **Practice address phone:** (212) 263-2573
- **Practice address fax:** (212) 263-2574
- **Mailing address:** 530 1ST AVE, HCC SUITE 3B, NEW YORK, NY 10016-6402
- **Mailing address phone:** (212) 263-2573
- **Mailing address fax:** (212) 263-2574

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/01/2007
- **Last updated:** 10/01/2007