Pro Form Sports Medicine And Wellness Associates

LBN: Pro Form Sports Medicine And Wellness Associates
Pro Form Sports Medicine And Wellness Associates is an health care organization with primary practice located at 201 Route 17 11Th Floor, Rutherford NJ 07070-2574. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as the primary health care specialty. Pro Form Sports Medicine And Wellness Associates can be contacted via phone (201) 549-8846, or through Park, Tae Keun via phone (646) 489-5640.

Contact Information

Primary practice address
201 Route 17 11Th Floor Rutherford NJ 07070-2574
Phone: (201) 549-8846
Fax: (201) 549-8839
Website:
Map and Directions
Authorized official contact:
Name: Park, Tae Keun Doctor of Medicine (MD)
Phone: (646) 489-5640

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207PS0010X 25MA08835000 New Jersey

Profile Details

NPI number 1235432972
LBN Legal business name Pro Form Sports Medicine And Wellness Associates
DBA Doing business as
Authorized official Park, Tae Keun Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 20th, 2010
Last updated Dec 20th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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