Individual
ELIZABETH PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
260 TREMONT ST FL 5, BOSTON, MA 02116-5603
(617) 636-5400
Mailing address
800 WASHINGTON STREET BOX: 212, BOSTON, MA 02111
(617) 636-1083
(617) 636-8319
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
283721
MA
207R00000X
Internal Medicine Physician
Q8990
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/07/2012
Last updated
09/29/2020
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