NPIMap

Organization Active NPI

Lisa Park, M.D. PLLC

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1780871947
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LISA PARK, M.D. PLLC
Practice address
530 1St Ave
HCC Suite 3B
New York, NY 10016-6402
Phone
(212) 263-2573
Fax
(212) 263-2574
NPI assigned
Oct 1, 2007
Last updated
Oct 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Dr. Lisa Park, M.D.
Title
Sole Owner
Phone
(212) 263-2573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

530 1St Ave
HCC Suite 3B
New York, NY 10016-6402

Mailing address

530 1St Ave
HCC Suite 3B
New York, NY 10016-6402
Phone (212) 263-2573

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1780871947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 1ST AVE",
            "address_2": "HCC SUITE 3B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-2573",
            "fax_number": "212-263-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 1ST AVE",
            "address_2": "HCC SUITE 3B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-2573",
            "fax_number": "212-263-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA PARK, M.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "212-263-2573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.