Park West Medical Associate PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

180533 Issued in NY

Legal business name

PARK WEST MEDICAL ASSOCIATE PLLC

Practice address

15 W 84TH St
1J
New York, NY 10024-4703

Phone

(212) 362-3020

Fax

(212) 362-3020

NPI assigned

Oct 30, 2009

Organization subpart

No

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

Authorized official

Name

Obunike O. Edokwe, M.D.

Title

Owner

Phone

(917) 940-2386

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1376879049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W 84TH ST",
            "address_2": "1J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244703",
            "telephone_number": "212-362-3020",
            "fax_number": "212-362-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W 84TH ST",
            "address_2": "1J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100244703",
            "telephone_number": "212-362-3020",
            "fax_number": "212-362-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK WEST MEDICAL ASSOCIATE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "EDOKWE",
        "authorized_official_first_name": "OBUNIKE",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-940-2386",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "180533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.