Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Palisades Park Pain & Rehabilitation Medicine, PA

Organization Nephrology Physician · NPI 1063647980

Palisades Park Pain & Rehabilitation Medicine, PA is a Nephrology Physician 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
Show map & directions

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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