Individual
DR. JANELLE LIRA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
580 COURT ST, KEENE, NH 03431-1729
(603) 354-5400
Mailing address
580 COURT ST, KEENE, NH 03431-1729
(603) 354-5400
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
23200
NH
2085R0001X
Radiation Oncology Physician
A78831
CA
2085R0001X
Radiation Oncology Physician
ME103816
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001497200
—
FL
01
—
146KH
BCBS
FL
01
—
331658
AVMED
FL
01
—
P00811542
RR MEDICARE
FL
Enumeration date
09/24/2006
Last updated
10/11/2022
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