MEDICARE: DR. HENRY PARK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	MD486618	PA
2	2084N0400X	Neurology Physician	25MA09507000	NJ
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	25MA09507000	NJ

General Provider Information

NPI Number	:	1427219807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY PARK MD

Provider Business Mailing Address
First Line	:	310 MADISON AVE STE 300
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6967
Country	:	US
Telephone Number	:	973-285-7800
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 MADISON AVE
Second Line	:	SUITE 300
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6967
Country	:	US
Telephone Number	:	973-285-7800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	03/13/2026

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