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General NPI Number Information
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NPI Number | 1124066048
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Entity Type | Organization
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Legal Business Name | UNITED MEDICAL PC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 612 RUTHERFORD AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-1217
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Country | US
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Telephone | 201-460-0063
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Fax | 201-460-1684
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Provider Business Mailing Address
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Address Line | 612 RUTHERFORD AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-1217
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Country | US
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Telephone | 201-460-0063
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Fax | 201-460-1684
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Authorized Official
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Title or Position | PRESIDENT
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Name | BYONG PARK
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Credential | M.D.
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Telephone | 201-460-0063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 933910
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA0352770
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 25MA08490600
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MA09171800
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 25MA08599900
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MA062232
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License Number State | NJ
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Taxonomy #7
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 25MA0497600
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License Number State | NJ
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Taxonomy #8
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA05208400
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License Number State | NJ
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Taxonomy #9
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25MA063700000
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License Number State | NJ
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Taxonomy #10
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 25MA08540700
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License Number State | NJ
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Taxonomy #11
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MA048966
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License Number State | NJ
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Taxonomy #12
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00326000
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License Number State | NJ
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Taxonomy #13
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA04562300
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License Number State | NJ
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