Healthcare Provider Details

I. General information

NPI: 1437073897
Provider Name (Legal Business Name): PARK HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W FRONT ST STE B1
PLAINFIELD NJ
07060-1173
US

IV. Provider business mailing address

400 W FRONT ST STE B1
PLAINFIELD NJ
07060-1173
US

V. Phone/Fax

Practice location:
  • Phone: 908-941-4910
  • Fax:
Mailing address:
  • Phone: 908-941-4910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: VIJAYA NIMMA
Title or Position: OWNER
Credential: MD
Phone: 908-941-4910