JAMIE PARK (NPI# 1477873107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477873107 |
| Entity Type | Individual |
| Full Name | JAMIE PARK |
| Credential | NP |
| Practice Address |
200 Grand Ave Ste 203 Englewood NJ 07631-4363 |
| Mailing Address |
24 Campbell Ave Airmont NY 10901-6302 |
| Practice Telephone | 2015880444 |
| Mailing Telephone | 8455383767 |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2016-12-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 02200576964 | NY | Nursing Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
F337600-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
26NR00439400 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073502035 | Jamie Y Park | Dentist | 8622 W Golf Rd, Niles, IL 60714-5600 | 2005-10-20 |
| 1033635180 | Jamie Lee Park | Pharmacist | 700 W Ironwood Dr, Coeur D Alene, ID 83814-2656 | 2017-08-21 |
| 1215472774 | Jamie Park | Pharmacist | 3900 W 3rd St, Los Angeles, CA 90020-2675 | 2016-12-19 |
| 1003290404 | Jamie L Park | Nurse Practitioner | 90 Shenango St, Greenville, PA 16125-2060 | 2015-07-15 |
| 1033445663 | Jamie Park | Physician Assistant | 2500 Belle Chasse Highway, Gretna, LA 70056-7127 | 2009-11-02 |
| 1194818401 | Jamie Joseph Park | Physical Therapist | 10 Crossroads Dr, Suite 208, Owings Mills, MD 21117-5458 | 2006-10-02 |
| 1578570040 | Jamie H Park | Dentist | 10680 Main St, Suite 150, Fairfax, VA 22030-3810 | 2006-08-01 |
| Street Address |
200 GRAND AVE STE 203 |
| City | ENGLEWOOD |
| State | NJ |
| Zip Code | 07631-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932125994 | Sung Wook Sun | Internal Medicine | 200 Grand Ave Ste 203, Englewood, NJ 07631-4363 | 2006-07-14 |
| 1548790306 | Seo Young Son | Nurse Practitioner | 200 Grand Ave Ste 203, Englewood, NJ 07631-4363 | 2017-06-14 |
| 1013394170 | Min Hwang | Nurse Practitioner | 200 Grand Ave Ste 203, Englewood, NJ 07631-4363 | 2015-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868922 | Sharmela Brijmohan | Student in an Organized Health Care Education/Training Program | 350 Engle Street Englewood Nj Department of Medicine, Englewood, NJ 07631 | 2020-07-21 |
| 1902422553 | Ross Tyrone Jensen Lavine | Student in an Organized Health Care Education/Training Program | 350 Engle Street, Department of Medicine, Englewood, NJ 07631 | 2020-06-19 |
| 1881235497 | Cbt and Psychodynamic Therapy Associates LLC | Social Worker | 245 Walnut Street, Englewood, NJ 07631 | 2019-10-04 |
| 1346895950 | Eb Care At Englewood, LLC | Assisted Living Facility | 412 South Van Brunt Street, Englewood, NJ 07631 | 2019-08-09 |
| 1730695727 | Maytal Elart | Spec/Tech, Cardiovascular | 151 E Palisades Ave, 16e, Englewood, NJ 07631 | 2017-12-28 |
| 1396259255 | Elizabeth Thottumalil Thomas | Counselor | 93 West Palisade Ave, Englewood, NJ 07631 | 2017-11-29 |
| 1992214381 | Englewood Orthopedics Group PC | Orthopaedic Surgery | 55 Smith St Unit 5653, Englewood, NJ 07631 | 2017-09-28 |
| 1639691579 | Jee Hoon Jang | Student in an Organized Health Care Education/Training Program | 350 Engle St., Englewood, NJ 07631 | 2017-07-12 |
| 1427570332 | Dan Ran Castillo | Student in an Organized Health Care Education/Training Program | 350 Engel Street, Engelwood, NJ 07631 | 2017-07-12 |
| 1275061392 | Thomas J Drexler | Counselor | 93 W. Palisades Ave, Englewood, NJ 07631 | 2017-06-02 |
| Find all providers in zip 07631 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508495821 | Jawana Lynn Watson | Nurse Practitioner | 307 Kristina Lynn Pl, Englewood, OH 45322-2354 | 2020-04-07 |
| 1003449737 | Michelle May Roe | Nurse Practitioner | 21 Oakland St, Englewood, NJ 07631-2112 | 2020-02-21 |
| 1528608197 | Ashley Lynn Thompson | Nurse Practitioner | 885 N Union Rd., Englewood, OH 45322 | 2020-01-13 |
| 1619518453 | Theresa Carol Lee | Nurse Practitioner | 420 Grand Ave Ste 101, Englewood, NJ 07631-4141 | 2019-10-02 |
| 1194373977 | Jane Uloma Ibe | Nurse Practitioner | 4018 Clearstream Way, Englewood, OH 45322-1458 | 2019-08-26 |
| 1932768330 | Laurie Ann Cucco | Nurse Practitioner | 3302 Riverview Ave, Englewood, NJ 07631-8720 | 2019-06-10 |
| 1326522848 | Quynh Doan | Nurse Practitioner | 2828 S Mccall Rd Ste 8, Englewood, FL 34224-9516 | 2018-09-20 |
| 1669998464 | Jennifer Diane Novotny | Nurse Practitioner | 3333 S Bannock St Ste 400, Englewood, CO 80110-2436 | 2017-08-14 |
| 1003366949 | Tiffany Kristine Lamarca | Nurse Practitioner | 2061 Englewood Rd Ste 5, Englewood, FL 34223 | 2016-10-04 |
| 1851844211 | Sm Medical LLC | Nurse Practitioner | 1008 Sunset Dr, Englewood, OH 45322-2253 | 2016-08-02 |
| Find all providers in ENGLEWOOD | ||||
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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.