Individual
DR. CHARLES W. PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
405 NORTHFIELD AVE, SUITE 204, WEST ORANGE, NJ 07052-3026
(973) 325-6120
(973) 325-6126
Mailing address
405 NORTHFIELD AVE, SUITE 204, WEST ORANGE, NJ 07052-3026
(973) 325-6120
(973) 325-6126
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
25MA07374100
NJ
2084P0800X
Psychiatry Physician
Primary
25MA07374100
NJ
Other
Enumeration date
09/26/2006
Last updated
12/18/2013
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