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SHANE PARK
NPI 1992551139
Student in an Organized Health Care Education/Training Program in Newark, NJ

Active since April 29, 2024
110 BERGEN ST, NEWARK, NJ 07103(973) 972-4620 Get Directions Write a Review

NPPES record last updated: April 29, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shane Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE PARK (NPI 1992551139) is an individual student in an organized health care education/training program in Newark, New Jersey and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1992551139
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameSHANE PARK
Location Address110 BERGEN STNewark, NJ 07103-2495
Mailing Address110 Bergen StNewark, NJ 07103-2495 · (973) 972-4620
Phone(973) 972-4620
Sole ProprietorNo
Enumeration DateApril 29, 2024
NPPES CertifiedApril 28, 2024
✔ NPI 1992551139 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
110 BERGEN ST, Newark, NJ 07103
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEAH SOOYEON NAM DMD
Student in an Organized Health Care Education/Training Program
110 BERGEN ST
NEWARK, NJ 07103
Essex County (973) 972-9592
DR. THOMAS GREGORY KEELING D.M.D.
Student in an Organized Health Care Education/Training Program
110 BERGEN ST, C723
NEWARK, NJ 07103
Essex County (973) 972-4621
DR. CHERYL LYNN BIBER D.M.D.
Dentist (General Practice)
110 BERGEN ST, UMDNJ - NEW JERSEY DENTAL SCHOOL
NEWARK, NJ 07103
Essex County (973) 972-0833
KEVIN LE DDS
Student in an Organized Health Care Education/Training Program
110 BERGEN ST
NEWARK, NJ 07103
Essex County (973) 972-3126
DR. JULYANA GOMES ZAGURY DMD, MSD
Dentist (General Practice)
110 BERGEN ST, RM D860
NEWARK, NJ 07103
Essex County (973) 972-7210
CLAUDIA SOTO
Dentist (General Practice)
110 BERGEN ST
NEWARK, NJ 07103
Essex County (862) 245-1222
DR. STEVEN MARK BAUM
Dentist (Oral and Maxillofacial Surgery)
110 BERGEN ST, UMDNJ DS C-768
NEWARK, NJ 07103
Essex County (973) 972-4717
DR. REBECCA REED DMD
Dentist
110 BERGEN ST, SUITE 7700
NEWARK, NJ 07103
Essex County (972) 972-2444

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Park's NPI number?

The NPI number for Shane Park is 1992551139. It was assigned to this individual provider in the NPPES registry on April 29, 2024.

Where is Shane Park located?

Shane Park practices at 110 Bergen St, Newark, NJ 07103. The listed phone number is (973) 972-4620.

What is Shane Park's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Shane Park was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.