Individual
JASON S PARK
Active
Individual
JASON S PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RP446664
PA
207N00000X
Dermatology Physician
Primary
332539-01
NY
207R00000X
Internal Medicine Physician
MT227888
PA
Other
Enumeration date
01/08/2021
Last updated
11/04/2025
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