MR. CHARLES PARK (NPI# 1215928072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215928072 |
| Entity Type | Individual |
| Full Name | MR. CHARLES PARK |
| Credential | P.A. |
| Practice Address |
150 Sargent Dr Suite 1 New Haven CT 06511-6100 |
| Practice Telephone | 2037814444 |
| Practice Fax Number | 2037898341 |
| Mailing Telephone | 2037814444 |
| Mailing Fax Number | 2037898341 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2014-12-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
000001 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | RAILROAD MEDICARE | 970011498 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891865499 | Charles C Park | Dentist | 1518 E Lincoln Ave, Orange, CA 92865-1928 | 2006-11-09 |
| 1639140023 | Charles Hee Yong Park | Dentist | 4290 Chain Bridge Rd Ste 202, Fairfax, VA 22030-8158 | 2006-02-01 |
| 1972704096 | Charles Park | Surgery | 234 Goodman St, Cincinnati, OH 45219-2364 | 2007-05-29 |
| 1235214131 | Charles Keyu Park | Psychiatry & Neurology | 8158 E 5th Ave, Suite 200, Denver, CO 80230-6444 | 2006-10-26 |
| 1629179411 | Charles W. Park | Counselor | 405 Northfield Ave, Suite 204, West Orange, NJ 07052-3026 | 2006-09-26 |
| 1669408571 | Charles Park | Anesthesiology | 7300 Medical Center Dr, West Hills, CA 91307-1902 | 2006-06-23 |
| 1861438517 | Charles C Park | Neurological Surgery | 301 St. Paul Place, Pob # 310, Baltimore, MD 21202 | 2006-06-21 |
| Street Address |
150 SARGENT DR SUITE 1 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511-6100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174513543 | Southern Connecticut Internal Medicine | Internal Medicine | 150 Sargent Dr, New Haven, CT 06511-6110 | 2005-10-26 |
| 1164787461 | Vanessa Arteaga Chen | Physician Assistant | 150 Sargent Dr, Suite 1, New Haven, CT 06511-6100 | 2012-07-12 |
| 1447513908 | Valerie A Flores | Obstetrics & Gynecology | 150 Sargent Dr, New Haven, CT 06511-6100 | 2012-06-20 |
| 1740571652 | Stephen Charles Collins | Obstetrics & Gynecology | 150 Sargent Dr, Second Floor, New Haven, CT 06511-6100 | 2011-04-26 |
| 1598999450 | Cindy M Duke | Obstetrics & Gynecology | 150 Sargent Dr, 2nd Floor, New Haven, CT 06511-6100 | 2009-05-07 |
| 1023205507 | J Ryan Martin | Obstetrics & Gynecology | 150 Sargent Dr, New Haven, CT 06511-6100 | 2007-09-28 |
| 1679605471 | Long Wharf Pediatrics & Adolescent Medicine LLC | Pediatrics | 150 Sargent Dr, Ste 6, New Haven, CT 06511-6100 | 2007-03-09 |
| 1346376316 | Medical Center Pharmacy | Pharmacy | 150 Sargent Dr, New Haven, CT 06511-6100 | 2007-02-26 |
| 1760562193 | Sandra Carson | Obstetrics & Gynecology | 150 Sargent Dr, New Haven, CT 06511-6100 | 2006-10-17 |
| 1811092182 | Southern Connecticut Internal Medicine | Internal Medicine | 150 Sargent Dr, Suite1, New Haven, CT 06511-6100 | 2006-09-13 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790319655 | Erin Kelly Flynn | Physician Assistant | 464 Congress Ave # Suie260, New Haven, CT 06519-1361 | 2020-02-28 |
| 1659919702 | Jeniece Kayla Wert | Physician Assistant | 100 Church Street South, Suite A230 Room A235, New Haven, CT 06519-1703 | 2019-12-18 |
| 1588121354 | Jason Michael Nies | Physician Assistant | 20 York St # 218, New Haven, CT 06510-3220 | 2019-02-27 |
| 1902334436 | Lauren Veronica Boggs | Physician Assistant | 45 Ley St, New Haven, CT 06512-3921 | 2017-05-29 |
| 1831353853 | Dina Weiner | Physician Assistant | 840 Howard Ave Fl 1, New Haven, CT 06519-1106 | 2008-07-18 |
| 1528244027 | Gerald Kayingo | Physician Assistant | 211 Fountain St, Apt 12, New Haven, CT 06515-1979 | 2008-01-14 |
| 1821219783 | Susanne Atkins | Physician Assistant | 175 Sherman Avenue, New Haven, CT 06511 | 2007-05-01 |
| 1023133626 | John Sceppa | Physician Assistant | Yale -new Haven Hospital, 20 York St., New Haven, CT 06510-3202 | 2007-03-20 |
| 1922147578 | Janice Decho | Physician Assistant | 20 York St Cb- 2041, New Haven, CT 06504-8900 | 2007-02-06 |
| 1578613964 | Brian Patrick Munday | Physician Assistant | 800 Howard Ave Lower Level, Comprehensive Epilepsy Center LLCi 716, New Haven, CT 06520-8018 | 2007-01-10 |
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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.