DR. CHAN WOO PARK


Address: 90 Bergen Street- Suite 8100, Department of Otolaryngology, Doc Building, Newark, NJ 07103
Phone: 9739724588

DR. CHAN WOO PARK (NPI# 1760644280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760644280
Entity Type Individual
Full Name DR. CHAN WOO PARK
Credential M.D.
Practice Address 90 Bergen Street- Suite 8100
Department of Otolaryngology, Doc Building
Newark
NJ 07103
Practice Telephone 9739724588
Mailing Telephone 9739724588
Enumeration Date 2008-06-26
Last Update Date 2013-11-04
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Y00000X Otolaryngology 25MA09356100 NJ Allopathic & Osteopathic Physicians
N 207Y00000X Otolaryngology MD60287386 WA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NY 1760644280 05

Other Providers CHAN PARK

NPI Name Taxonomy Address Enumeration
1144828963 Chan Ho Park Physician Assistant 4721 Oakwood Ave, Los Angeles, CA 90004-3112 2020-10-14
1508404492 Chan Jin Park Acupuncturist 21537 48th Ave Apt 2b, Bayside, NY 11364-1359 2019-12-11
1700147378 Chan H Park Internal Medicine 22226 Cliff Ave S, #304, Des Moines, WA 98198-4619 2012-05-30
1700092103 Chan Hoon Park Family Medicine 905 Victory Hwy, Slatersville, RI 02876 2007-05-15
1871617027 Chan M Park Dentist 111 Deerwood Rd Ste 130, San Ramon, CA 94583-2194 2007-03-16
1457467037 Chan M Park Family Medicine 6460 Greensboro Rd, Ridgeway, VA 24148-3478 2006-08-23
1619940681 Chan S. Park Emergency Medicine Michumi, Pllc Dba Med Express of Williamsburg, Va, 120 Monticello Ave, Williamsburg, VA 23185 2006-02-09
1255336665 Chan H. Park Family Medicine 9500 Stockdale Hwy, Suite 203, Bakersfield, CA 93311-3620 2005-06-14
1366071045 Chan Young Park Student in an Organized Health Care Education/Training Program 11301 Wilshire Blvd Bldg 500, Los Angeles, CA 90073-1003 2020-04-05
1932498722 Chan Jerome Park Thoracic Surgery (Cardiothoracic Vascular Surgery) 600 Highland Ave, Madison, WI 53792-0001 2011-03-31

Office Location

Street Address 90 BERGEN STREET- SUITE 8100
DEPARTMENT OF OTOLARYNGOLOGY, DOC BUILDING
City NEWARK
State NJ
Zip Code 07103

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124657077 Yingna Liu Student in an Organized Health Care Education/Training Program Medical Science Building, 185 South Orange Avenue, Newark, NJ 07103 2020-04-03
1568029684 Martins Akhibi Nurse Practitioner 178 Newton Street, Newark, NJ 07103 2019-05-23
1972168482 Newark Renaissance House, Inc Rehabilitation, Substance Use Disorder Unit 50-56 Norfolk Street, Newark, NJ 07103 2019-05-09
1346709235 Ian Wang Yu Student in an Organized Health Care Education/Training Program 185 South Orange Ave., Medical Science Building, Room I-506, Newark, NJ 07103 2019-03-19
1437648417 Stephen Vanbeek Internal Medicine 185 S Orange Ave Rm 547, Newark, NJ 07103 2018-05-06
1073019444 Geoffrey Alexander Talis Student in an Organized Health Care Education/Training Program 183 S. Orange Avenue, Level E, Room 1452, Newark, NJ 07103 2018-04-03
1285139907 Thomas Georg Bachmann Student in an Organized Health Care Education/Training Program 185 South Orange Ave, Medical Science Building, G-538, Newark, NJ 07103 2018-03-26
1154825289 Shammi A Patel Student in an Organized Health Care Education/Training Program 185 S Orange Ave # Msbg594, Newark, NJ 07103 2018-03-22
1982122545 North Jersey Aids Alliance Clinic/Center 393 Central Avenue C/o Corey Destefano, Newark, NJ 07103 2017-09-05
1134655533 Yasmin N Abedin Student in an Organized Health Care Education/Training Program 185 South Orange Ave, Msb E-506, Rutgers, New Jersey Medical School, Newark, NJ 07103 2017-05-04
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Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467639864 Jagdeep Singh Hundal Otolaryngology 774 Christiana Rd Ste B4, Newark, DE 19713-4219 2008-01-28
1588745483 Shaun R Roof Otolaryngology 88 Mcmillen Drive, Newark, OH 43055 2006-10-18
1083646442 Licking Memorial Professional Corporation Otolaryngology 88 Mcmillen Dr, Newark, OH 43055-5814 2006-07-07
1932102134 Joseph I Ramzy Otolaryngology 774 Christiana Rd, Suite 107, Newark, DE 19713-4236 2005-05-23
1699225227 University Physician Associates of New Jersey, Inc Otolaryngology 30 Bergen St, Admc 1205, Newark, NJ 07107-3000 2016-10-06
1497137491 First State Ent Association Inc Otolaryngology 774 Christiana Road, Neuroscience Building Ste B4, Newark, DE 19713-4236 2015-06-25
1649618596 Dylan Francis Roden Otolaryngology 90 Bergen St # 8100, Newark, NJ 07103 2013-06-12
1407113921 Wayne Daniel Hsueh Otolaryngology 90 Bergen St Ste 8100, Newark, NJ 07103-2425 2012-04-20
1033405139 Bradley R Lawson Otolaryngology 36 Mcmillen Dr, Newark, OH 43055 2011-06-27
1861783615 Rachel Kaye Otolaryngology 90 Bergen St Ste 8100, Newark, NJ 07103-2425 2011-04-27
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City NEWARK
Zip Code 07103

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Dataset Information

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.

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