Individual
MISS AMY Y PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
714 31ST ST, UNION CITY, NJ 07087-2427
(201) 863-7077
Mailing address
770 JACKSON ST APT 840, HOBOKEN, NJ 07030-6973
(630) 267-1993
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26NJ01069700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ01069700
NJ APN LICENSE NUMBER
NJ
Enumeration date
11/04/2020
Last updated
11/04/2020
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