Individual
EUGENE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.AC, PA-C
Contact information
Practice address
458 WEST ST, FORT LEE, NJ 07024-3408
(201) 474-7700
Mailing address
24A E EDSALL BLVD, PALISADES PARK, NJ 07650-3626
(323) 304-4832
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
25MZ00169700
NJ
171100000X
Acupuncturist
7437
NY
171100000X
Acupuncturist
AC8570
CA
363A00000X
Physician Assistant
Primary
025055
NY
363A00000X
Physician Assistant
25MP00577600
NJ
363A00000X
Physician Assistant
PA18721
CA
Other
Enumeration date
01/15/2007
Last updated
01/12/2024
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