SEONGAE PARK (NPI# 1528273075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528273075 |
| Entity Type | Individual |
| Full Name | SEONGAE PARK |
| Practice Address |
1825 Kennedy Boulevard Jersey City NJ 07305 |
| Mailing Address |
1491 Carlisle Rd North Brunswick NJ 08902-1465 |
| Practice Telephone | 2015476100 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2009-11-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
26NJ00112200 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1825 KENNEDY BOULEVARD |
| City | JERSEY CITY |
| State | NJ |
| Zip Code | 07305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467436519 | Surendra P Khera | Internal Medicine | 1825 Kennedy Boulevard, 1st Floor, Jersey City, NJ 07305-2106 | 2005-12-02 |
| 1699980193 | Candace Delgaudio | Nurse Practitioner | 1825 Kennedy Boulevard, Jersey City, NJ 07305 | 2007-05-10 |
| 1871663039 | Greenville Hospital | General Acute Care Hospital | 1825 Kennedy Boulevard, Ececutive Office, Jersey City, NJ 07305-2106 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518584358 | Lloyd Maquiling | Physical Therapist | 198 Old Bergen Rd #2622, Jersey City, NJ 07305 | 2020-06-27 |
| 1487293932 | Acj Consultants, Inc. | Counselor | 1600 Kennedy Blvd, Jersey City, NJ 07305 | 2020-01-02 |
| 1942767066 | Carerivet Medical Services LLC | Clinic/Center | 26 University Place Blvd, 1st Floor, Jersey City, NJ 07305 | 2019-02-25 |
| 1538669759 | Marie Day | Home Health Aide | 1709 Kennedy Boulevard, Jersey City, NJ 07305 | 2018-02-14 |
| 1881100162 | Heather Primus | Assistant Behavior Analyst | 120 Seaview Avenue, Ground Floor, Jersey City, NJ 07305 | 2017-12-21 |
| 1932642816 | Reem H Salem | Physical Therapist | 2120 John F Kennedy Blvd, Jersey City, NJ 07305 | 2016-11-28 |
| 1629449020 | Anjanie Persaud | Pharmacist | 260 Armstrong Ave, Jersey City, NJ 07305 | 2015-10-12 |
| 1518334440 | Acme Markets Inc | Durable Medical Equipment & Medical Supplies | 321 State Rt 440, Jersey City, NJ 07305 | 2015-08-26 |
| 1306212832 | Hudson Milestones | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9-11 Kensington Avenue, Jersey City, NJ 07305 | 2015-08-19 |
| 1144628397 | Martin Rodriguez | Counselor | 110 Martin Luther Drive, Jersey City, NJ 07305 | 2014-12-19 |
| Find all providers in zip 07305 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184757817 | Natasha Rose Carew | Nurse Practitioner | 1856 Jfk Blvd, Jersey City, NJ 07305-2122 | 2007-03-13 |
| 1801403027 | Maikel Herrera Ynfiesta | Nurse Practitioner | 355 Grand St, Jersey City, NJ 07302-4321 | 2020-09-30 |
| 1396367231 | Stephanie Salinas | Nurse Practitioner | 355 Grand St, Jersey City, NJ 07302-4321 | 2020-05-14 |
| 1639706286 | Ijechi Ndidi Ngumah | Nurse Practitioner | 355 Grand St, Jersey City, NJ 07302-4321 | 2020-03-24 |
| 1770053746 | Theresa Dijoseph | Nurse Practitioner | 355 Grand St, Jersey City, NJ 07302-4321 | 2018-12-03 |
| 1073041257 | Tiffany De Leon-wurm | Nurse Practitioner | 355 Grand St, Jersey City, NJ 07302-4321 | 2017-06-01 |
| 1184158784 | Eva Villar-trinidad | Nurse Practitioner | 355 Grand Street, Jersey City Medical Center/rwj Barnabas Health, Jersey City, NJ 07302 | 2017-04-20 |
| 1518398361 | David Wilkenson Newton | Nurse Practitioner | 450 Ocean Ave, Jersey City, NJ 07305-3274 | 2013-12-04 |
| 1326346933 | Jessica M Marino | Nurse Practitioner | 355 Grand St, Jersey City, NJ 07302-4321 | 2011-03-06 |
| 1588993125 | Jasmine Garces-king | Nurse Practitioner | 176 Palisade Ave, Jersey City, NJ 07306-1121 | 2009-12-10 |
| Find all providers in JERSEY CITY | ||||
| City | JERSEY CITY |
| Zip Code | 07305 |
Please comment or provide details below to improve the information on SEONGAE PARK.
| 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.