Young Park, MD | |
350 Boulevard, Passaic, NJ 07055-2840 | |
(973) 365-4300 | |
Not Available |
Full Name | Young Park |
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Gender | Male |
Speciality | Anesthesiology |
Location | 350 Boulevard, Passaic, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982645453 | NPI | - | NPPES |
0550302 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | MA25969 (New Jersey) | Primary |
Entity Name | Advanced Ambulatory Anesthesia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063415990 PECOS PAC ID: 9335134170 Enrollment ID: O20040420000134 |
Mailing Address | Practice Location Address |
---|---|
Young Park, MD Po Box 343, Midland Park, NJ 07432-0343 Ph: (201) 804-2800 | Young Park, MD 350 Boulevard, Passaic, NJ 07055-2840 Ph: (973) 365-4300 |
Dr. Chang J Lee, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 350 Boulevard, Passaic, NJ 07055 Phone: 973-779-7361 Fax: 973-779-7385 | |
Dr. Michael E. Rhodes, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 165 Amsterdam Ave, Passaic, NJ 07055 Phone: 973-336-9459 Fax: 973-883-0144 | |
Dr. Sujatha Sukhavasi, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 350 Boulevard, Passaic, NJ 07055 Phone: 973-365-4300 Fax: 845-357-5777 | |
Dr. Ravi Kumar Venkataraman, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 350 Boulevard, Passaic, NJ 07055 Phone: 973-779-7361 Fax: 973-779-7385 | |
Dariusz J Nasiek, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 350 Boulevard, Passaic, NJ 07055 Phone: 973-365-4300 | |
Nandi Lee-ellis, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 350 Boulevard, Passaic, NJ 07055 Phone: 973-365-4300 Fax: 845-357-5777 | |
Benjamin George, M.D., Anesthesiology Medicare: Medicare Enrolled Practice Location: 211 Pennington Ave, Passaic, NJ 07055 Phone: 973-779-7361 Fax: 973-779-7385 |