Healthcare Provider Details

I. General information

NPI: 1851719843
Provider Name (Legal Business Name): CHRISTINE J PARK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

200 ELM ST N
ONAMIA MN
56359-7901
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number83325
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: