Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Palisades Park Pain & Rehabilitation Medicine, PA

Organization Nephrology Physician · NPI 1063647980

Palisades Park Pain & Rehabilitation Medicine, PA provides Nephrology Physician services in Ridgefield, New Jersey. Licensed in New Jersey. Registered with an NPI since 2009.

Licensed in
NJ
In the registry since
2009
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

784 Grand Ave Ste 301
Ridgefield, NJ 07657-1043
Phone: (201) 944-1124
Fax: (201) 699-0406
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence MA58515 (NJ)

Record details

NPI number1063647980
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wonil Park — President · (201) 944-1124
NPI enumeratedMay 21, 2009
Last updated in NPPESMay 7, 2020
Certification dateMay 7, 2020
Mailing address784 Grand Ave Ste 301, Ridgefield, NJ 07657-1043

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