Charles Park, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

000001 Issued in CT

Practice address

150 Sargent Dr
Suite 1
New Haven, CT 06511-6100

Phone

(203) 781-4444

Fax

(203) 789-8341

NPI assigned

Nov 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1215928072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SARGENT DR",
            "address_2": "SUITE 1",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116100",
            "telephone_number": "203-781-4444",
            "fax_number": "203-789-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SARGENT DR",
            "address_2": "SUITE 1",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116100",
            "telephone_number": "203-781-4444",
            "fax_number": "203-789-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "000001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970011498",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunil Parikh, MD
• Manuel Paris Jr., PSY.D.
• Laura Parisi, LPC
• Michael J Parisi, RPT
• Betsey Park, PA-C
• Dae Yong Park, MD
• Gee Yoon Park, DO
• Henry Soo-Min Park, M.D., M.P.H.
• Jaehan Park, DDS
• Kyung Park, MD

• Medical Physician Assistant in New Haven, CT
• Providers in New Haven, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.