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General NPI Number Information
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NPI Number | 1447544879
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Entity Type | Individual
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Provider Name | JOEL CHOI PARK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2011
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 525 E 68TH ST
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City | NEW YORK
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State | NY
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Zip | 10065-4870
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Country | US
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Telephone | 908-278-1328
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Fax |
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Provider Business Mailing Address
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Address Line | 25 BIRCH ST
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City | BEACHWOOD
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State | NJ
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Zip | 08722-4632
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Country | US
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Telephone | 908-278-1328
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 279480
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License Number State | NY
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