Chonghyo Thomas Park, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MA68348 Issued in NJ

Practice address

44 Sylvan Ave
Suite 2C
Englewood Cliffs, NJ 07632-2426

Phone

(201) 242-1002

Fax

(201) 242-1012

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073629200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 PRISCILLA LN",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322328",
            "telephone_number": "201-541-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 SYLVAN AVE",
            "address_2": "SUITE 2C",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322426",
            "telephone_number": "201-242-1002",
            "fax_number": "201-242-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHONGHYO",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA68348",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "187394-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7931107",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Panda Care Texas Sub LLC
• Paris Imaging, PC
• Park Chiropractic Clinic, LLC
• Bosco Seongyeol Park, PT, DPT
• Cheonil Park, DC
• Ducksoon Park, D.C.
• Hai Sun Park, M.D.
• Jung Joo Park, D.M.D.
• Seo Hyun Park
• Pascack Valley Medical Care PC (Pascack Valley Medical Care Center)

• Pediatrics Physician in Englewood Cliffs, NJ
• Providers in Englewood Cliffs, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.