NPI 1487843587 · live from the CMS NPI Registry
Jung Ha Park, O.D.
Optometrist in Middletown, DE. National Provider Identifier 1487843587, active.
NPI record
| NPI | 1487843587 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 223 E Main St, Middletown, DE 19709 |
| Practice phone | 302-376-1900 |
| Mailing address | 8614 Westwood Center Dr Fl 9, Vienna, VA 22182 |
| Enumerated | October 15, 2007 |
| Last updated | October 14, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | OPT002988 (GA) |
| Optometrist primary | 152W00000X | I3-0011437 (DE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.