Park, Chan Soo
Park, Chan Soo is an individual health care provider with primary practice located at 205 South Ave Suite 103, Poughkeepsie NY 12601-4818. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Park, Chan Soo can be contacted via phone (845) 454-2360.Contact Information
Primary practice address
205 South Ave Suite 103
Poughkeepsie NY 12601-4818
Phone: (845) 454-2360
Fax: (845) 454-2361
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 127160 | New York |
Profile Details
| NPI number | 1861485484 |
|---|---|
| LBN Legal business name | Park, Chan Soo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861485484 | NPPES |
| New York | MEDICAID | 00503613 |
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