person
Mr. Charles Park, PA
Medical Physician Assistant in New Haven, Connecticut
NPI 1215928072

Charles Park is a Medical Physician Assistant based in New Haven, CT and is specialized in Medical. Charles Park practices in New Haven, CT and has the professional credentials of PA. The NPI Number for Charles Park is 1215928072 and holds a License No. 000001 (Connecticut).

The current practice location address for Charles Park is 150 Sargent Dr, New Haven, CT and can be reached out via phone at 203-781-4444 and via fax at 203-789-8341.

Location: 150 Sargent Dr, New Haven, CT, 06511-6100
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Provider Profile Details
NPI Number
1215928072
Provider Name
Charles Park
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
150 Sargent Dr, New Haven, CT, 06511-6100
Phone Number
203-781-4444
Fax Number
203-789-8341
Provider Enumeration Date
11/02/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
970011498 01 CT RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
150 Sargent Dr
City
State
Zip
06511-6100
Phone Number
203-781-4444
Fax Number
203-789-8341
person
Provider Business Mailing Address Details
Address
150 Sargent Dr
City
State
Zip
06511-6100
Phone Number
203-781-4444
Fax Number
203-789-8341
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
000001 (Connecticut)
Definition
Definition to come...
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