Individual
CHIN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
500 W 57TH ST, NEW YORK, NY 10019-2902
(212) 293-3000
Mailing address
79 HAVEN AVE, APT 34, NEW YORK, NY 10032-2717
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
653355
NY
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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