Individual
DR. BRIAN EDWARD PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
103 E 86TH ST, NEW YORK, NY 10028-1058
(212) 369-0531
(212) 369-4654
Mailing address
103 E 86TH ST, NEW YORK, NY 10028-1058
(212) 369-0531
(212) 369-4654
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
189223
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01446822
—
NY
Enumeration date
12/21/2006
Last updated
07/09/2007
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