Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHANG S S PARK, M.D
DeactivatedCHANG S S PARK, M.D is a Specialist healthcare provider located in PALISADES PARK, New Jersey. NPI 1275554610 is deactivated in the NPPES registry. Verify at CMS.
Specialist · PALISADES PARK, NJ
This NPI has been deactivated.
The record was deactivated on April 18, 2016.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1275554610
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 21, 2006 (9.7431693989071 yrs)
- Last Updated
- Aug 2, 2016
- Deactivated
- Apr 18, 2016
- License
-
25MA07699600 (NJ)
Practice Information
- Address
-
118 BROAD AVE N9PALISADES PARK, NJ, 07650Browse NJ providers · Browse ZIP 07650
- Phone
- 2014820439
- Fax
- 2014828703
- Primary Specialty
-
Specialist
174400000X
Other Specialist Providers in PALISADES PARK, NJ
| Name | Credential | NPI |
|---|---|---|
| MRS. JULIANA A VASQUEZ | MS.ED | 1255693164 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.