Individual
MR. TAE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1450 CHAPEL ST, PHARMACY DEPARTMENT, NEW HAVEN, CT 06511-4405
(203) 789-6095
Mailing address
20823 32ND AVE, BAYSIDE, NY 11361-1042
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051114
NY
183500000X
Pharmacist
Primary
10553
CT
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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