Richard Michael Parke, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00053400 Issued in NJ

Practice address

155 W Hudson Ave
Englewood, NJ 07631-1609

Phone

(201) 871-8882

NPI assigned

Jan 14, 2019

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1104390061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 IRON LATCH RD",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W HUDSON AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311609",
            "telephone_number": "201-871-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKE",
        "first_name": "RICHARD",
        "middle_name": "MICHAEL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-14",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00053400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jin Hyun Park
• Mie Hea Park
• Sae Yeon Park, APN
• Selin Park, FNP
• Yoojun Park, DDS
• Caroline Parpas, MD
• Pascack Valley Hospital
• Pascack Valley Surgical Association PA
• Felicia Maria Pasculli
• Annalisa Pastore, M.D.

• Physical Therapy Assistant in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.