Dr Park'S Pain Management, PC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

25MA07699600 Issued in NJ

Legal business name

DR PARK'S PAIN MANAGEMENT, PC

Practice address

1638 Schlosser St
D4 Ste 1
Fort Lee, NJ 07024-5650

Phone

(201) 543-8218

NPI assigned

Feb 18, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Chang S Park, MD

Title

President

Phone

(201) 543-8218

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1972825883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 SCHLOSSER ST",
            "address_2": "D4 STE 1",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245650",
            "telephone_number": "201-543-8218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 SCHLOSSER ST",
            "address_2": "D4 STE 1",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245650",
            "telephone_number": "201-543-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR PARK'S PAIN MANAGEMENT, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "CHANG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-543-8218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07699600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275554610",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Anesthesiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.