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General NPI Number Information
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NPI Number | 1760171508
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Entity Type | Organization
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Legal Business Name | PARK PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 1020 SOUTHHILL DR STE 320
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City | CARY
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State | NC
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Zip | 27513-8629
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Country | US
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Telephone | 919-213-8758
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Fax |
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Provider Business Mailing Address
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Address Line | 459 S GREENSBORO ST
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City | CARRBORO
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State | NC
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Zip | 27510-2354
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Country | US
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Telephone | 617-721-1271
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Fax |
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Authorized Official
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Title or Position | MANAGER/EMPLOYEE
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Name | DR. ELIZA MYUNG PARK
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Credential | MD
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Telephone | 617-721-1271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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