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

Jae Park

Individual provider Physical Therapist · NPI 1033530910

Jae Park is a Physical Therapist in Private Practice in Marlboro, New Jersey. Qualified in 2013, 13 years ago. Practices with Advanced Wellness, an 18-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
13
Licensed in
NJ
In the registry since
2013
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Practice location Address checks out

17 N Main St
Marlboro, NJ 07746-1439
Phone: (732) 431-2155
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA01528600 (NJ)

Record details

NPI number1033530910
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 19, 2013
Last updated in NPPESDecember 19, 2013
Mailing address17 N Main St, Marlboro, NJ 07746-1439

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Advanced Wellness — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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