Individual
YOUNG PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 BOULEVARD, PASSAIC, NJ 07055-2840
(973) 365-4300
Mailing address
PO BOX 343, MIDLAND PARK, NJ 07432-0343
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MA25969
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0550302
—
NJ
Enumeration date
06/08/2006
Last updated
10/15/2007
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