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Organization
MANHATTAN MEDICAL PHYSICIAN PLLC
Active
Organization
MANHATTAN MEDICAL PHYSICIAN PLLC
Active
Other names
Susan Park, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN PARK MD (OWNER)
(212) 427-1642
Entity
Organization
Contact information
Practice address
1150 PARK AVE, NEW YORK, NY 10128-1244
(212) 427-1642
(646) 351-0685
Mailing address
1150 PARK AVE, NEW YORK, NY 10128-1244
(212) 427-1642
(646) 351-0685
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2327981
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02642831
—
NY
01
—
2327981
NY LICENSE
NY
Enumeration date
10/21/2010
Last updated
10/21/2010
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