Organization
PRO FORM SPORTS MEDICINE AND WELLNESS ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAE KEUN PARK MD (PARTNER)
(646) 489-5640
Entity
Organization
Contact information
Practice address
201 ROUTE 17, 11TH FLOOR, RUTHERFORD, NJ 07070-2574
(201) 549-8846
(201) 549-8839
Mailing address
201 ROUTE 17, 11TH FLOOR, RUTHERFORD, NJ 07070-2574
(201) 549-8846
(201) 549-8839
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
25MA08835000
NJ
Other
Enumeration date
12/20/2010
Last updated
12/20/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us