MR. CHARLES PARK P.A. NPI 1215928072

NPI Information

  • NPI: 1215928072
  • Provider Name: MR. CHARLES PARK, P.A.
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 150 SARGENT DR
    SUITE 1
    NEW HAVEN, CT
    ZIP 06511
  • Phone: (203) 781-4444

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NPI Details

MR. Charles Park, P.A. is a medical physician assistant in New Haven, CT. MR. Charles Park, P.A. NPI is 1215928072. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

150 SARGENT DR
SUITE 1
NEW HAVEN, CT
ZIP 06511-100
Phone: (203) 781-4444
Fax: (203) 789-8341

The enumeration date for this NPI number is 11/2/2005 and was last updated on 12/8/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical000001CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1970011498OTHERCONNECTICUTRAILROAD MEDICARE
2S91545MEDICARE UPINCONNECTICUT
3970000444MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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