So Hyun Park, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR01158300 Issued in NJ

Practice address

101 N Grove St
East Orange, NJ 07017-4712

Phone

(973) 672-1700

NPI assigned

Feb 19, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• At Home by Enhance Therapies LLC

  • Physical Therapist
  • Lakewood, NJ
  • NPI 1124603246

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1073319240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 15TH ST APT 12H",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242027",
            "telephone_number": "949-322-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N GROVE ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070174712",
            "telephone_number": "973-672-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SO HYUN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR01158300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Concepcion C Paras, R.N.
• Park Avenue Chiropractic PC
• Park Grove Healthcare & Rehabilitation Center LLC
• Esther Park
• Sangjun Park, PHARMD
• Yeojin Park
• Yong Moo Park, M.D.
• Antoinette Parks
• Parkway Manor Health Center, LLC
• Thais Pascal

• Occupational Therapist in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.