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

Jaehyun Park

Individual provider Physical Therapist · NPI 1114706082

Jaehyun Park is a Physical Therapist in Private Practice in North Bergen, New Jersey. Qualified in 2020, 6 years ago. Accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
6
Licensed in
NJ, NY
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

7400 River Rd Apt 310
North Bergen, NJ 07047-7228
Phone: (617) 817-5979
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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 048827-01 (NY)
Physical Therapist Taxonomy 225100000X · Licence 40QA02095200 (NJ)

Record details

NPI number1114706082
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 28, 2023
Last updated in NPPESSeptember 28, 2023
Certification dateAugust 1, 2023
Mailing address7400 River Rd Apt 310, North Bergen, NJ 07047-7228

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in North Bergen