Bergen Medical Care PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BERGEN MEDICAL CARE PC

Practice address

110 Broad Ave Ste 7
Palisades Park, NJ 07650-2722

Phone

(718) 887-4858

NPI assigned

May 27, 2022

Last updated

May 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel D Park, DO

Title

Owner

Phone

(718) 887-4858

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Haenam Yun, MD

  • Pediatrics Physician
  • Palisades Park, NJ
  • NPI 1013077874
  NPD (past)

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1396484416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BROAD AVE STE 7",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BROAD AVE STE 7",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502722",
            "telephone_number": "718-887-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN MEDICAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-887-4858",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://portal.care360.com/care360/Care360SSOSecurityCheck",
            "affiliation": "N",
            "address_1": "110 Broad Ave Ste 7",
            "city": "Palisades Park",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "076502722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Balance Dizziness Center Inc.
• Bareun Spine Clinic
• Edward R Baron, LCSW, BCD
• Robert Marcel Benedetti, D.M.D.
• Bergen Adult Day Care Inc
• Michelle Beyrich
• Book Kyung Holistic Center, PC
• Borough of Palisades Park
• Borough of Palisades Park (Palisades Park EMS)
• BP and JJ LLC (Pine Pharmacy)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.