Organization Active NPI

Park Avenue Maxillary & Mandibular Restorations PC

  • Ambulatory Surgical Clinic/Center
  • New York, NY
National Provider Identifier
1235532870
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
440777 Issued in NY
Legal business name
PARK AVENUE MAXILLARY & MANDIBULAR RESTORATIONS PC
Practice address
563 Park Ave
New York, NY 10065-7379
Phone
(212) 838-0383
NPI assigned
Sep 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Pasquale Malpeso, D.M.D.NPI 1073647772
Title
President
Phone
(212) 838-0090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 440777 NY Primary

Addresses

Primary practice location

563 Park Ave
New York, NY 10065-7379

Mailing address

563 Park Ave
New York, NY 10065-7379

Other identifiers 1

IdentifierTypeStateIssuer
440777OtherNYTHE JOINT COMMISSION

National Provider Directory

National Provider Directory
Tax ID family
Park Avenue Maxillary Mandibular Restoration PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1235532870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657379",
            "telephone_number": "212-838-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE MAXILLARY & MANDIBULAR RESTORATIONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "MALPESO",
        "authorized_official_first_name": "PASQUALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-838-0090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "440777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE JOINT COMMISSION",
            "identifier": "440777",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.