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General NPI Number Information
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NPI Number | 1306441340
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Entity Type | Individual
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Provider Name | JONATHAN S PARK PHARMD, CSP
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Gender | Male
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 2024 LEHIGH ST STE 600
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City | ALLENTOWN
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State | PA
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Zip | 18103-4994
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Country | US
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Telephone | 610-402-2748
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Fax | 610-402-5228
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Provider Business Mailing Address
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Address Line | 2024 LEHIGH ST STE 600
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City | ALLENTOWN
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State | PA
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Zip | 18103-4994
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Country | US
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Telephone | 610-402-2748
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Fax | 610-402-5228
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI04069900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202221874
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP453911
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License Number State | PA
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