Individual
DR. CHONG H PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., F.R.C.S.(US)
Contact information
Practice address
775 BLOOMFIELD AVE, MONTCLAIR, NJ 07042-1880
(973) 509-3401
(973) 655-1560
Mailing address
775 BLOOMFIELD AVE, MONTCLAIR, NJ 07042-1880
(973) 509-3401
(973) 655-1560
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
25MA04390700
NJ
208VP0014X
Interventional Pain Medicine Physician
Primary
25MA04390700
NJ
Other
Enumeration date
12/28/2006
Last updated
03/29/2013
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