Mie Hea Park

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP019778 Issued in PA

Practice address

475 Grand Ave
2ND Floor
Englewood, NJ 07631-4965

Phone

(201) 541-1111

NPI assigned

Jan 5, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1902294598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2290 GALLOWAY RD APT B9",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190202956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 GRAND AVE",
            "address_2": "2ND FLOOR",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314965",
            "telephone_number": "201-541-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MIE HEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00544400",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP019778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheleen Chaerin Park, PHARMD
• David Joon Park, MD
• Jamie Park, NP
• Jason Park, OTR/L
• Jin Hyun Park
• Sae Yeon Park, APN
• Selin Park, FNP
• Yoojun Park, DDS
• Richard Michael Parke, PTA
• Caroline Parpas, MD

• Nurse Practitioner in Englewood, NJ
• Providers in Englewood, 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 Feb 8, 2019; 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.