Park, Chan Woo

Park, Chan Woo is an individual health care provider with primary practice located at 90 Bergen Street- Suite 8100 Department Of Otolaryngology, Doc Building, Newark NJ 07103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Park, Chan Woo can be contacted via phone (973) 972-4588.

Contact Information

Primary practice address
90 Bergen Street- Suite 8100 Department Of Otolaryngology, Doc Building Newark NJ 07103
Phone: (973) 972-4588
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X MD60287386 Washington
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 25MA09356100 New Jersey

Profile Details

NPI number 1760644280
LBN Legal business name Park, Chan Woo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2008
Last updated Nov 4th, 2013 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760644280 NPPES
New York MEDICAID 1760644280

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