Park, Jong Keun

Park, Jong Keun is an sole proprietor health care provider with primary practice located at 232 Broad Ave Ste 208 , Palisades Park NJ 07650-1565. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Park, Jong Keun can be contacted via phone (201) 346-0999.

Contact Information

Primary practice address
232 Broad Ave Ste 208 Palisades Park NJ 07650-1565
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 25MA08373800 New Jersey

Profile Details

NPI number 1386816858
LBN Legal business name Park, Jong Keun
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 25th, 2008
Last updated Mar 25th, 2008 - about 16 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 1386816858 NPPES
New Jersey Other 25MA08373800 NJ STATE LICENSE

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