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Individual

SOO-MI MI PARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
493 ESSEX AVENUE, HACKENSACK, NJ 07601-1215
(201) 996-9244
(201) 996-9243
Mailing address
493 ESSEX AVENUE, HACKENSACK, NJ 07601-1215
(201) 996-9244
(201) 996-9243

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
237492
NY
207R00000X
Internal Medicine Physician
25MA08918200
NJ
207RC0000X
Cardiovascular Disease Physician
25MA08918200
NJ
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
25MA08918200
NJ

Other

Enumeration date
03/21/2007
Last updated
10/15/2013
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