Park, Jennifer E

Park, Jennifer E is an individual health care provider with primary practice located at 301 Sullivan Way , West Trenton NJ 08628-3406. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Park, Jennifer E can be contacted via phone (609) 633-1562.

Contact Information

Primary practice address
301 Sullivan Way West Trenton NJ 08628-3406
Phone: (609) 633-1562
Fax: (609) 633-8527
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MA05702000 New Jersey

Profile Details

NPI number 1770674525
LBN Legal business name Park, Jennifer E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated Jul 9th, 2007 - about 17 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 1770674525 NPPES
New Jersey MEDICAID 8328803

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