Provider Demographics
NPI:1811905045
Name:PARK, YOUNG K (MD)
Entity type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:K
Last Name:PARK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:115 CHRISTOPHER COLUMBUS DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-5526
Mailing Address - Country:US
Mailing Address - Phone:201-435-3055
Mailing Address - Fax:201-435-3198
Practice Address - Street 1:115 CHRISTOPHER COLUMBUS DR
Practice Address - Street 2:SUITE 201
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-5526
Practice Address - Country:US
Practice Address - Phone:201-435-3055
Practice Address - Fax:201-435-3198
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2010-02-01
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Provider Licenses
StateLicense IDTaxonomies
NJMA 031193207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine