Individual
JEONG IN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
2182 LEMOINE AVE, FORT LEE, NJ 07024-6009
(120) 154-3864
(201) 482-4905
Mailing address
2182 LEMOINE AVE, FORT LEE, NJ 07024-6009
(201) 482-4705
(201) 482-4905
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI02461600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RI02461600
NJ BOARD OF PHARMACY
NJ
Enumeration date
01/08/2021
Last updated
01/08/2021
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