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General NPI Number Information
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NPI Number | 1841426319
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Entity Type | Individual
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Provider Name | ANDREW PARK D.O., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 333 E 43RD ST APT 220
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City | NEW YORK
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State | NY
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Zip | 10017-4814
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Country | US
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Telephone | 646-509-3362
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Fax | 484-303-7854
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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 | 032-0134126
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | OP60948379
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 00243361
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 322420
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License Number State | NY
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