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Individual

MS. SEOUN H PARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
992 CLIFTON AVE, CLIFTON, NJ 07013-3502
(862) 249-1266
Mailing address
16A MARA RD, LAKE HIAWATHA, NJ 07034-1350
(201) 602-2726

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
680166
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ15069000
NJ

Other

Enumeration date
01/27/2014
Last updated
10/08/2024
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