Park, Yong Moo
Park, Yong Moo is an individual health care provider with primary practice located at 300 Central Ave , East Orange NJ 07018-2819. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Park, Yong Moo can be contacted via phone (973) 672-8400.Contact Information
Primary practice address
300 Central Ave
East Orange NJ 07018-2819
Phone: (973) 672-8400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MA 26048 | New Jersey |
Profile Details
| NPI number | 1356345722 |
|---|---|
| LBN Legal business name | Park, Yong Moo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2005 |
| Last updated | Dec 26th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356345722 | NPPES |
| New Jersey | MEDICAID | 0670308 |
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