Park, Peter B.

Park, Peter B. is an individual health care provider with primary practice located at 300 Perrine Rd Suite 301, Old Bridge NJ 08857-3627. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Park, Peter B. can be contacted via phone (732) 727-8346.

Contact Information

Primary practice address
300 Perrine Rd Suite 301 Old Bridge NJ 08857-3627
Phone: (732) 727-8346
Fax: (732) 727-8345
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 25MA07085300 New Jersey
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 25MA07085300 New Jersey

Profile Details

NPI number 1487609723
LBN Legal business name Park, Peter B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Jul 21st, 2014 - about 10 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 1487609723 NPPES
New Jersey MEDICAID 0001236

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