Organization
SPARK MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL PARK (MD)
(732) 523-4057
Entity
Organization
Contact information
Practice address
143 E RIDGEWOOD AVE UNIT 454, RIDGEWOOD, NJ 07451-7022
(732) 523-4057
Mailing address
143 E RIDGEWOOD AVE UNIT 454, RIDGEWOOD, NJ 07451-7022
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/31/2025
Last updated
10/31/2025
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