Provider Demographics
NPI:1942805460
Name:PARK, HELEN SONG (RPH)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:SONG
Last Name:PARK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2226
Mailing Address - Country:US
Mailing Address - Phone:973-379-2833
Mailing Address - Fax:
Practice Address - Street 1:8 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-2226
Practice Address - Country:US
Practice Address - Phone:973-379-2833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12663183500000X
NY047142-01183500000X
NJ28RI02696200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist