Palisades Park Pain & Rehabilitation Medicine, PA

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MA58515 Issued in NJ

Legal business name

PALISADES PARK PAIN & REHABILITATION MEDICINE, PA

Practice address

784 Grand Ave Ste 301
Ridgefield, NJ 07657-1043

Phone

(201) 944-1124

Fax

(201) 699-0406

NPI assigned

May 21, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Wonil Park, MD

Title

President

Phone

(201) 944-1124

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Jungsun Yoo, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Englewood, NJ
  • NPI 1225348022
  NPD
• Ned Lloyd Namoc Ruiz, PHYSICAL THERAPIST

  • Physical Therapist
  • Englewood, NJ
  • NPI 1225353774
  NPD (past)
• Ricardo Erlano, PHYSICAL THERAPIST

  • Physical Therapist
  • New York, NY
  • NPI 1881617066
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1063647980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 GRAND AVE STE 301",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571043",
            "telephone_number": "201-944-1124",
            "fax_number": "201-699-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 GRAND AVE STE 301",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571043",
            "telephone_number": "201-944-1124",
            "fax_number": "201-699-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALISADES PARK PAIN & REHABILITATION MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-21",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "WONIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-944-1124",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MA58515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeastern Acupuncture
• Nova Health Group LLC
• Cristymay Ocampo
• Joan M. Oconnell, LSW
• Aida A Opao, MD
• Park Dental Arts, LLC
• Park Dental Associates, Inc
• Wonil Park, M.D.
• Partners Medical Supplies Inc.
• Aditiben Kanubhai Patel

• Nephrology Physician in Ridgefield, NJ
• Providers in Ridgefield, NJ by specialty
• Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.