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Contact Information

YONGTACK PARK
800 PALISADE AVENUE
#308
FORT LEE, NJ07024
 Phone: 347-334-6860
 Fax: 347-602-8662
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for YONGTACK PARK · (Male)

NPI Number 1144576331
Status Active
Credentials
Entity Individual
Enumeration date 07/25/2012
Last updated 11/08/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 017697
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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