Park, Benjamin L

Park, Benjamin L is an individual health care provider with primary practice located at 1 Guthrie Sq , Sayre PA 18840-1625. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Park, Benjamin L can be contacted via phone (570) 887-5583.

Contact Information

Primary practice address
1 Guthrie Sq Sayre PA 18840-1625
Phone: (570) 887-5583
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X OS017425 Pennsylvania
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1205121639
LBN Legal business name Park, Benjamin L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2011
Last updated Mar 4th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205121639 NPPES
Pennsylvania MEDICAID 1030313710001

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