ALICE SOO PARK

PHILADELPHIA, PA
NPI1851693055
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: PA  SP012125)
Additional Taxonomies163W00000X Registered Nurse
(Licence: NY  567761)
163W00000X Registered Nurse
(Licence: NJ  26NR14281300)
163W00000X Registered Nurse
(Licence: PA  RN635789)
Enumeration Date2010-11-22
Last Update Date2013-02-20
Business Address
-- ALICE SOO PARK NP
3401 N BROAD ST
PHILADELPHIA, PA 19140-5103
Phone number: 215-707-3375
Mailing Address
-- ALICE SOO PARK NP
2450 W HUNTING PARK AVE
PHILADELPHIA, PA 19129-1302
Phone number: 215-707-4739