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General NPI Number Information
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NPI Number | 1902721384
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Entity Type | Organization
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Legal Business Name | PARK NJ PODIATRY PC
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 392 BEDFORD PARK BLVD
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City | BRONX
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State | NY
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Zip | 10458-2415
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Country | US
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Telephone | 201-916-0735
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Fax |
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Provider Business Mailing Address
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Address Line | 60 COLGATE ST
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City | CLOSTER
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State | NJ
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Zip | 07624-1508
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Country | US
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Telephone | 201-916-0735
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TERRENCE PARK
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Credential | DPM
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Telephone | 201-916-0735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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