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Contact Information

CHRISTIAN J PARK
80 STATE HWY 310
SUITE 1
CANTON, NY13617
 Phone: 315-386-2189
 Fax: 315-386-2435
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for CHRISTIAN J PARK · (Male)

NPI Number 1487106969
Status Active
Credentials
Entity Individual
Enumeration date 10/31/2016
Last updated 11/02/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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