Organization
PALISADES PARK MEDICINE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYUNGKON KENNETH CHOI M.D. (OWNER)
(201) 638-8156
Entity
Organization
Contact information
Practice address
340 BROAD AVE, PALISADES PARK, NJ 07650-2618
(201) 592-1112
Mailing address
340 BROAD AVE, PALISADES PARK, NJ 07650-2618
(201) 592-1112
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2MA05329300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7179405
—
NJ
Enumeration date
03/13/2012
Last updated
03/13/2012
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