Individual
JEFFREY D PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2601 HOLME AVE, PHILA, PA 19152-2007
(215) 335-6200
Mailing address
2601 HOLME AVE, PHILA, PA 19152-2007
(215) 407-4848
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN521643L
PA
Other
Enumeration date
06/09/2005
Last updated
11/24/2014
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