Park, Sun Ja

Park, Sun Ja is an individual health care provider with primary practice located at 1435 Liberty St , Hamilton NJ 08629-2220. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Park, Sun Ja can be contacted via phone (609) 599-5433.

Contact Information

Primary practice address
1435 Liberty St Hamilton NJ 08629-2220
Phone: (609) 599-5433
Fax: (609) 475-4661
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X

Profile Details

NPI number 1992056311
LBN Legal business name Park, Sun Ja
Credentials MSRD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2012
Last updated Sep 25th, 2012 - about 13 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 1992056311 NPPES
New Jersey MEDICAID 0169129

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