Organization
PARK PSYCHOLOGY PLLC
Active
Organization
PARK PSYCHOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL J PARK PSYD (OWNER)
(646) 504-3596
Entity
Organization
Contact information
Practice address
1115 BROADWAY FL 12, NEW YORK, NY 10010-3452
(646) 504-3596
Mailing address
1115 BROADWAY FL 12, NEW YORK, NY 10010-3452
(646) 504-3596
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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