Individual
CHANGHEE PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
30 WINTER ST, BOSTON, MA 02108-4720
(617) 426-0600
Mailing address
30 WINTER ST, BOSTON, MA 02108-4720
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
2307013
MA
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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