ELLEN PARK (NPI# 1619075413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619075413 |
| Entity Type | Individual |
| Full Name | ELLEN PARK |
| Credential | D.D.S. |
| Practice Address |
625 Elmwood Ave Box 683 Rochester NY 14620-2913 |
| Practice Telephone | 5852755087 |
| Mailing Telephone | 5852755087 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740892645 | Ellen Park | Occupational Therapist | 3148 W 11th St, Los Angeles, CA 90006-2322 | 2020-08-20 |
| 1528313863 | Ellen Miyoung Park | Counselor | 3261 Ne 100th St, Seattle, WA 98125-7816 | 2012-07-23 |
| 1821327826 | Ellen Jung Park | Occupational Therapist | 14119 Deerbrook Ln, Chino Hills, CA 91709-4807 | 2009-12-22 |
| 1174090179 | Ellen Sunghee Park | Pharmacist | 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806 | 2018-10-28 |
| 1619475043 | Ellen Park | Occupational Therapist | 3350 La Jolla Village Dr, San Diego, CA 92161-0002 | 2018-01-31 |
| 1922559442 | Ellen Sae Eun Park | Nurse Practitioner | 2232 Sepulveda Blvd, Torrance, CA 90501-5301 | 2016-10-19 |
| 1508310673 | Ellen Park | Dentist | 620 Alabama St, Redlands, CA 92373-8059 | 2016-08-06 |
| 1568712362 | Ellen Park | Optometrist | 1689 Arden Way, Sacramento, CA 95815-4030 | 2012-09-19 |
| 1801057732 | Ellen Jiwon Park | Anesthesiology | 1500 San Pablo St, 4th Floor Anes, Los Angeles, CA 90033-5313 | 2008-06-23 |
| 1821104191 | Ellen S Park | Radiology | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2006-08-21 |
| Street Address |
625 ELMWOOD AVE BOX 683 |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14620-2913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104853886 | Charles M. Oster | Dentist | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2006-06-27 |
| 1588273353 | Omar Said | Dentist | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2020-07-28 |
| 1215545785 | Mohammad Mahjoorighasrodashti | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2020-07-21 |
| 1467060384 | Barbara Sterniczuk | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2020-07-16 |
| 1285252460 | Brandon Hersh | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2020-07-14 |
| 1588272793 | Giuseppe Carvelli | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2020-07-14 |
| 1528683018 | Monica Amorim Da Silva Gusmini | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2020-06-10 |
| 1538783436 | Andrew Boshra | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2020-06-05 |
| 1396367207 | Aaron Masaru Miyamoto | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2020-05-13 |
| 1033731955 | Sukhmeet Singh Gujral | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2020-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974174 | Linda D Pratt | Speech-Language Pathologist | Rochester Hearing and Speech Center, 1000 Elmwood Ave Suite 400, Rochester, NY 14620 | 2020-02-20 |
| 1609417617 | Maisie Katherine Pipher | Physician Assistant | 110 Crittenden Blvd, Rochester, NY 14620 | 2019-10-01 |
| 1215592332 | Allison Mckeown | Student in an Organized Health Care Education/Training Program | 777 S. Clinton Avenue - Box Hh 37, Rochester, Ny 14620, Box Hh 37, Rochester, NY 14620 | 2019-05-03 |
| 1114495736 | Tabitha Domonique Griffin | Licensed Practical Nurse | 55 Forthill Terrace, Rochester, NY 14620 | 2018-11-13 |
| 1700371960 | Deborah Paul | Dermatology | 40 Celebration Dr # 697, Rochester, NY 14620 | 2018-06-28 |
| 1942725791 | Emily Catone | Nurse Practitioner | 252 Cobb Terrace, Rochester, NY 14620 | 2017-08-12 |
| 1104355593 | Acacia Palmer | Counselor | 150 Mount Hope Avenue, Rochester, NY 14620 | 2017-06-08 |
| 1750818803 | Meagan Michelle Goates | Student in an Organized Health Care Education/Training Program | 150 Crittenden Blvd, Rochester, NY 14620 | 2017-05-20 |
| 1386170470 | Kendall Battle | Licensed Practical Nurse | 479 South Ave Apt B, Rochester, NY 14620 | 2017-05-10 |
| 1285167700 | Gina Josette Kuehn | Student in an Organized Health Care Education/Training Program | 40 Celebration Dr # 278733, Rochester, NY 14620 | 2017-04-11 |
| Find all providers in zip 14620 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174130421 | Carolyne Copley | Student in an Organized Health Care Education/Training Program | 226 2nd St Sw, Rochester, MN 55905-0001 | 2020-09-29 |
| 1497362925 | Alexandra Michelle Hasiotis | Student in an Organized Health Care Education/Training Program | 36 Copperfield Rd, Rochester, NY 14615-1102 | 2020-09-29 |
| 1750905873 | Anna C Lin | Student in an Organized Health Care Education/Training Program | 419 7th Ave Sw, Rochester, MN 55902-3216 | 2020-06-04 |
| 1558985101 | Erin Marissa Hannigan | Student in an Organized Health Care Education/Training Program | 4802 8th St Sw, Rochester, MN 55902-8711 | 2020-05-29 |
| 1710501408 | Anna Dowling | Student in an Organized Health Care Education/Training Program | 609 E 2650 North Rd, Rochester, IL 62563-8108 | 2020-05-29 |
| 1689296386 | Bryan Liming Jan | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave # 632, Rochester, NY 14642-0001 | 2020-05-15 |
| 1780206474 | Robert Tainsh | Student in an Organized Health Care Education/Training Program | 601 Elmwood Avenue Box 604, Rochester, NY 14642-0001 | 2020-05-15 |
| 1578185302 | Shaahin Dadjoo | Student in an Organized Health Care Education/Training Program | 625 Elmwood Ave Ofc 683, Rochester, NY 14620-2913 | 2020-05-14 |
| 1578185534 | Starling Tolliver | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave # Ac-5696, Rochester, NY 14642-0001 | 2020-05-13 |
| 1548882707 | Christian A Archer | Student in an Organized Health Care Education/Training Program | 601 Elmwood Avenue Box Hh 37, Rochester, NY 14642-0001 | 2020-05-11 |
| Find all providers in ROCHESTER | ||||
Please comment or provide details below to improve the information on ELLEN 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.