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General NPI Number Information
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NPI Number | 1780760132
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Entity Type | Individual
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Provider Name | HO-HYUN PARK M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/28/2006
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Last Update Date | 12/18/2008
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Provider Practice Location Address
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Address Line | 521 PLYMOUTH RD SUITE 106
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1638
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Country | US
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Telephone | 610-941-3390
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Fax | 610-941-3391
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Provider Business Mailing Address
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Address Line | 1322 SUSQUEHANNA RD
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City | RYDAL
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State | PA
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Zip | 19046-1827
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Country | US
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Telephone | 215-572-5404
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Fax | 215-572-1184
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD-031306-L
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License Number State | PA
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