Individual
DR. JANE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
478 BRICK BLVD, BRICK, NJ 08723-6077
(732) 701-4848
(732) 701-1244
Mailing address
478 BRICK BLVD, BRICK, NJ 08723-6077
(732) 701-4848
(732) 701-1244
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD434270
PA
208C00000X
Colon & Rectal Surgery Physician
Primary
MD434270
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02188022
—
NJ
Enumeration date
01/19/2007
Last updated
10/24/2013
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