MR. TAE PARK (NPI# 1043308984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043308984 |
| Entity Type | Individual |
| Full Name | MR. TAE PARK |
| Credential | PHARM.D. |
| Practice Address |
1450 Chapel St Pharmacy Department New Haven CT 06511-4405 |
| Mailing Address |
20823 32nd Ave Bayside NY 11361-1042 |
| Practice Telephone | 2037896095 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 10553 | CT | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 051114 | NY | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710273156 | Tae Sook Park | Acupuncturist | 903 S. Crenshaw Blvd, 302, Los Angeles, CA 90019 | 2011-06-23 |
| 1790870996 | Tae H Park | Dentist | 1875 E Alluvial Ave, Suite 102, Fresno, CA 93720-3856 | 2006-10-04 |
| 1336230259 | Tae K Park | Internal Medicine | 724 8th Ave, Brooklyn, NY 11215-4204 | 2006-09-27 |
| 1376560805 | Tae Sung Park | Neurological Surgery | 1 Childrens Pl Fl 1, 1st Fl, Saint Louis, MO 63110-1002 | 2006-07-17 |
| 1346297660 | Tae J. Park | Internal Medicine | 512 W Rosedale St, Fort Worth, TX 76104-4619 | 2006-05-30 |
| 1538133020 | Tae Won Park | Psychiatry & Neurology | 1547 S Wayne Rd, Westland, MI 48186 | 2006-02-14 |
| 1275015364 | Tae Park | Pharmacist | 1640 Hopkins Rd, Williamsville, NY 14221-1752 | 2018-09-05 |
| 1669751772 | Tae E Park | Pharmacist | 230 Park Ave, M-sp1-01, Florham Park, NJ 07901 | 2011-08-05 |
| 1093940249 | Tae Keun Park | Emergency Medicine | 300 Community Dr, Department of Emergency Medicine, Manhasset, NY 11030-3816 | 2009-05-18 |
| 1932141942 | Tae Park | Radiology | University Hospital L2, Stony Brook, NY 11794-0001 | 2006-06-12 |
| Street Address |
1450 CHAPEL ST PHARMACY DEPARTMENT |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511-4405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649272949 | Bhupesh Mangla | Internal Medicine | 1450 Chapel St, Department of Medicine, Hospital of Saint Raphael, New Haven, CT 06511-4405 | 2005-06-01 |
| 1326652108 | Christiana Moustakas O'hara | Speech-Language Pathologist | 1450 Chapel St, New Haven, CT 06511-4405 | 2020-08-31 |
| 1699388728 | Travis Pyka | Registered Nurse | 1450 Chapel St, New Haven, CT 06511-4405 | 2020-08-28 |
| 1013527423 | Julie Lynn West | Psychiatry & Neurology | 1450 Chapel St, New Haven, CT 06511-4405 | 2020-08-01 |
| 1801405840 | Melina Catherine Proto | Registered Nurse | 1450 Chapel St, New Haven, CT 06511-4405 | 2020-07-27 |
| 1053935163 | Hilary Bartholomay | Nurse Practitioner | 1450 Chapel St, New Haven, CT 06511-4405 | 2020-06-04 |
| 1932728151 | Stephanie Mock | Physician Assistant | 1450 Chapel St, New Haven, CT 06511-4405 | 2020-04-09 |
| 1407415169 | Lisa Hanna | Pharmacist | 1450 Chapel St, New Haven, CT 06511-4405 | 2019-06-06 |
| 1841859667 | Russell Clifford Sage | Pharmacist | 1450 Chapel St, New Haven, CT 06511-4405 | 2019-06-06 |
| 1194384933 | Emily Tiglio | Pharmacist | 1450 Chapel St, New Haven, CT 06511-4405 | 2019-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194330571 | Allison Elizabeth Pratt | Occupational Therapist | 625 Whitney Ave, Apt 5, New Haeven, CT 06511 | 2020-09-11 |
| 1881213346 | Sarah Bleicher | Registered Nurse | Yale Health, 55 Lock St, New Haven, CT 06511 | 2020-04-14 |
| 1083268395 | Danielle Lee Mcpherson | Pharmacist | Yale New Haven Hospital 55 Park Street, New Haven, CT 06511 | 2019-07-25 |
| 1528533866 | Alexia Levin | Social Worker | 98/100 York St, New Haven, CT 06511 | 2018-10-12 |
| 1861970097 | Orthocare Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 1450 Chapel St Ste Sg15, New Haven, CT 06511 | 2018-07-31 |
| 1609352418 | Susannah Frew | Social Worker | 2 Eld Street, Apt 6, New Haven, CT 06511 | 2018-07-15 |
| 1851881965 | Empowerment Counseling Services, LLC | Counselor | 427 Dixwell Ave, New Haven, CT 06511 | 2018-05-14 |
| 1487173951 | Karine Giasson-gariepy | Student in an Organized Health Care Education/Training Program | Yale University Department of Psychiatry, 300 George Street, Suite 901, New Haven, Ct 06511, New Haven, CT 06511 | 2017-09-15 |
| 1568980696 | Anna Reutenauer | Dentist | 123 York St Ste 4l, New Haven, CT 06511 | 2017-09-08 |
| 1083134753 | Darin Dolezal | Student in an Organized Health Care Education/Training Program | 200 South Frontage Road, Ep2 2nd Floor - 612, Dept of Pathology, New Haven, CT 06511 | 2017-06-23 |
| Find all providers in zip 06511 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336757319 | Matthew Peter O'connell | Pharmacist | 55 Park Street, Lower Level, Department of Pharmacy, New Haven, CT 06510 | 2020-07-16 |
| 1477171460 | Huy Henry Le | Pharmacist | 20 York Street, Ps-ll, New Haven, CT 06510 | 2020-07-07 |
| 1487212635 | Brittany Clarissa Langdon | Pharmacist | 1450 Chapel St Rm V140n, New Haven, CT 06511-4405 | 2019-06-03 |
| 1841704277 | Daniela Alzate-molina | Pharmacist | 249 Legion Ave, New Haven, CT 06519-5508 | 2017-11-21 |
| 1639694698 | Sunil Kumar Tickoo | Pharmacist | Berneys Pharmacy, 615 Howard Ave, New Haven, CT 06519-2112 | 2017-08-10 |
| 1265893143 | Leon Cushman | Pharmacist | 1168 Whalley Ave, New Haven, CT 06515-1705 | 2016-03-18 |
| 1871997627 | Bhumi Patel | Pharmacist | 44 Orange St, Apt 523, New Haven, CT 06510-3130 | 2014-10-22 |
| 1356612634 | David Eld | Pharmacist | 55 Park Street, Suite 1a, New Haven, CT 06511 | 2012-01-19 |
| 1780954719 | Rebecca Reeve | Pharmacist | 53 Park St, New Haven, CT 06511-5474 | 2012-01-06 |
| 1841568441 | Pamela Cavallo | Pharmacist | 55 Park St., New Haven, CT 06511 | 2011-12-09 |
| Find all providers in NEW HAVEN | ||||
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| 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.