Angela Marie Park, PHARM. D.

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

PH00062284 Issued in WA

Practice address

421 N. Main St
Department of Veterans Affairs Medical Center
Leeds, MA 01053

Phone

(413) 584-4040

NPI assigned

Aug 28, 2007

Sex

Female

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

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1457545014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N MAIN ST",
            "city": "LEEDS",
            "state": "MA",
            "postal_code": "010539764",
            "telephone_number": "413-584-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N. MAIN ST",
            "address_2": "DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER",
            "city": "LEEDS",
            "state": "MA",
            "postal_code": "01053",
            "telephone_number": "413-584-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH00062284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Leeds, MA
• Providers in Leeds, MA by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.