Sool Lip Park

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ00903400 Issued in NJ

Practice address

85 Waldron Ave
Glen Rock, NJ 07452-2830

Phone

(718) 974-8596

NPI assigned

Mar 28, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sool Lip Shin Former name

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": "1774656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774656000000",
    "number": "1881533271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 E RIDGEWOOD AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WALDRON AVE",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074522830",
            "telephone_number": "718-974-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SOOL LIP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-28",
        "last_updated": "2026-03-28",
        "certification_date": "2026-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00903400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOOL LIP",
            "last_name": "SHIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Orthopaedic Associates of Fair Lawn, LLC
• Orthopedic Associates of New Jersey
• Lyndsay Joan Pace, LSW
• Mayuri Ashok Panchal
• Virahi Parikh
• Karan Patel, DPT
• Sujal P Patel, MD
• Vishnu G Patel, PHARMD
• Patient Care Solutions Inc
• Alexander Pedicone, LCSW

• Nurse Practitioner in Glen Rock, NJ
• Providers in Glen Rock, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2026; 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.