Individual
JANE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4422 3RD AVE, BRONX, NY 10457-2545
(718) 960-9000
(718) 960-9361
Mailing address
1424 OUTLOOK AVE APT 1, BRONX, NY 10465-1184
(718) 883-0012
(718) 960-9361
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F347367
NY
Other
Enumeration date
08/05/2021
Last updated
01/10/2022
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