CHANG S S PARK (NPI# 1275554610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275554610 |
| Entity Type | Individual |
| Full Name | CHANG S S PARK |
| Credential | M.D |
| Practice Address |
118 Broad Ave N9 Palisades Park NJ 07650 |
| Practice Telephone | 2014820439 |
| Practice Fax Number | 2014828703 |
| Mailing Telephone | 2014820439 |
| Mailing Fax Number | 2014828703 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2016-08-02 |
| NPI Deactivation Date | 04/18/2016 |
| NPI Reactivation Date | 2016-05-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 25MA07699600 | NJ | Other Service Providers |
| Street Address |
118 BROAD AVE N9 |
| City | PALISADES PARK |
| State | NJ |
| Zip Code | 07650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356902134 | Balance Dizziness Center Inc. | Psychiatry & Neurology | 17 Brinkerhoff Terrace, Palisades Park, NJ 07650 | 2019-06-24 |
| 1437631371 | Catherine Jang | Pharmacist | 113 Roosevelt Pl, Palisades Park, NJ 07650 | 2018-09-06 |
| 1063911782 | Jinwoo Kim | Acupuncturist | 58w Oakdene Ave, Unit A, Palisades Park, NJ 07650 | 2018-02-08 |
| 1275053563 | Prime Painmanagement PC | Physical Medicine & Rehabilitation | 118-126 Broad Avenue, Unit 11, Palisades Park, NJ 07650 | 2017-06-27 |
| 1366836520 | George Xenakis, Dds, Palisades Park, LLC | Clinic/Center | 261a Broad Ave, Palisades Park, NJ 07650 | 2015-03-26 |
| 1245637842 | Sun Young Lee | Nurse Practitioner | 11 West Harriet Ave, Apt 102, Palisades Park, NJ 07650 | 2014-11-25 |
| 1063824290 | Daehwan Ji | Acupuncturist | 460 Bergen Blvd Suite #304, Palisades Park, NJ 07650 | 2014-05-22 |
| 1295084739 | Minhyun Cho | Counselor | 19 E Central Blvd, Palisades Park, NJ 07650 | 2012-08-30 |
| 1255693164 | Juliana A Vasquez | Specialist | 446 7th Street, Palisades Park, NJ 07650 | 2012-06-15 |
| 1295019529 | Now Pain Clinc PC | Residential Treatment Facility, Physical Disabilities | 21 Grand Ave #502, Palisades Park, NJ 07650 | 2011-10-05 |
| Find all providers in zip 07650 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255693164 | Juliana A Vasquez | Specialist | 446 7th Street, Palisades Park, NJ 07650 | 2012-06-15 |
| 1205915600 | Jhuns Medical PC | Specialist | 21 Grand Ave Ste 501, Palisades Park, NJ 07650-1083 | 2006-11-04 |
| 1588114060 | Prime Diagnostics, P.C. | Specialist | 118 Broad Ave, N9, Palisades Park, NJ 07650-2717 | 2016-10-10 |
| 1518104249 | Luke Eyerman, Md, LLC | Specialist | 103 Grand Ave, Palisades Park, NJ 07650-1007 | 2009-01-16 |
| 1134394687 | Metrovision Inc | Specialist | 540 Bergen Blvd, Palisades Park, NJ 07650-2322 | 2008-04-25 |
| 1851470256 | Steve Jy Jhun | Specialist | 21 Grand Ave Ste 501, Palisades Park, NJ 07650-1083 | 2006-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817356 | Erica Strubbe-montalvo | Specialist | 135 Larch Ave, Bogota, NJ 07603-1504 | 2020-10-08 |
| 1154937076 | Ines P Serna | Specialist | 7312 Kiesel Pl, North Bergen, NJ 07047-4033 | 2020-09-16 |
| 1568077238 | Michelle Horowitz-firestone | Specialist | 5 Whitman Ter, Long Branch, NJ 07740-9310 | 2020-09-10 |
| 1811509946 | Iris Devaughn | Specialist | 218 High St Apt 6, Burlington City, NJ 08016-4420 | 2020-08-19 |
| 1083223572 | Enlyv Clinics | Specialist | 908 Oak Tree Ave Ste R, South Plainfield, NJ 07080-5135 | 2020-07-30 |
| 1235748971 | North Jersey Sports Medicine & Orthopedic Center, LLC | Specialist | 254b Mountain Ave Ste 201, Hackettstown, NJ 07840-2413 | 2020-07-29 |
| 1255958864 | Tiffany Nicole Pierce | Specialist | 730 Newark Ave Apt 12d, Jersey City, NJ 07306-2816 | 2020-06-30 |
| 1699391557 | Brojan Franchising Inc | Specialist | 76 Highland Trl, Denville, NJ 07834-2033 | 2020-06-17 |
| 1487274288 | Kyle Everage | Specialist | 129 Passaic Ave # 201, Kearny, NJ 07032-1105 | 2020-04-21 |
| 1548880644 | Michal Lasowsky | Specialist | 1 Idaho St, Passaic, NJ 07055-3336 | 2020-04-20 |
| Find all providers with the same taxonomy | ||||
| City | PALISADES PARK |
| Zip Code | 07650 |
Please comment or provide details below to improve the information on CHANG S S PARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.