Organization
DR PARK'S PAIN MANAGEMENT, PC
Active
Organization
DR PARK'S PAIN MANAGEMENT, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANG S PARK MD (PRESIDENT)
(201) 543-8218
Entity
Organization
Contact information
Practice address
1638 SCHLOSSER ST, D4 STE 1, FORT LEE, NJ 07024-5650
(201) 543-8218
Mailing address
1638 SCHLOSSER ST, D4 STE 1, FORT LEE, NJ 07024-5650
(201) 543-8218
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA07699600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275554610
NPI
NJ
Enumeration date
02/18/2010
Last updated
02/18/2010
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