Palisades Park Medicine, P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2MA05329300 Issued in NJ

Legal business name

PALISADES PARK MEDICINE, P.C.

Practice address

340 Broad Ave
Palisades Park, NJ 07650-2618

Phone

(201) 592-1112

NPI assigned

Mar 13, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kyungkon Kenneth Choi, M.D.NPI 1760579064

Title

Owner

Phone

(201) 638-8156

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

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

• Kyungkon Kenneth Choi, MD

  • Infectious Disease Physician
  • Palisades Park, NJ
  • NPI 1760579064
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1093080871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BROAD AVE",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502618",
            "telephone_number": "201-592-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BROAD AVE",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502618",
            "telephone_number": "201-592-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALISADES PARK MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "KYUNGKON",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-638-8156",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "2MA05329300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7179405",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Silvia Edelina Ordonez, COTA
• Michael Ostrofsky, D.D.S.
• Pal Park Physical Therapy PC
• Palisades Park Bo Orthodontics
• Palisades Park Dental P.C.
• Palisades Park School District
• Palpark Physical Therapy
• Maria Elena Parisi
• Chang S S Park, M.D
• Hyewon Park, DNP

• Internal Medicine Physician in Palisades Park, NJ
• Providers in Palisades Park, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.