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General NPI Number Information
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NPI Number | 1831498666
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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 | 03/18/2011
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 19 E 27TH ST
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City | BAYONNE
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State | NJ
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Zip | 07002-4608
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Country | US
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Telephone | 201-339-6111
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Fax | 201-339-6333
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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 & MEDICAL DIRECTOR
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Name | DR. 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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00343600
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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 | 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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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MB05924000
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA07920500
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License Number State | NJ
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Taxonomy #7
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MA06564500
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License Number State | NJ
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Taxonomy #8
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 25MD00232400
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License Number State | NJ
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Taxonomy #9
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA04594000
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License Number State | NJ
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