Park Avenue Maxillary & Mandibular Restoration PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0386071 Issued in NY

Legal business name

PARK AVENUE MAXILLARY & MANDIBULAR RESTORATION PC

Practice address

563 Park Ave
New York, NY 10065-7379

Phone

(212) 838-0090

Fax

(212) 935-1296

NPI assigned

Jan 25, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia Ponce

Title

Office Supervisor

Phone

(212) 838-0090

Specialties & licenses 1

Addresses

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.

• Park Avenue Maxillary & Mandibular Restorations PC

  • Ambulatory Surgical Clinic/Center
  • New York, NY
  • NPI 1235532870
  NPD tax ID

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1457656381",
    "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",
            "telephone_number": "212-838-0090",
            "fax_number": "212-935-1296"
        },
        {
            "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": "212-838-0090",
            "fax_number": "212-935-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE MAXILLARY & MANDIBULAR RESTORATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "PONCE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OFFICE SUPERVISOR",
        "authorized_official_telephone_number": "212-838-0090",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "0386071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Avenue Imaging LLC
• Park Avenue Mammography
• Park Avenue Mammography
• Park Avenue Manhattan Medical Services, P.C.
• Park Avenue Maternal-Fetal Medicine PLLC
• Park Avenue Maxillary & Mandibular Restorations PC
• Park Avenue Medical & Surgical Associates
• Park Avenue Medical Care PC
• Park Avenue Medical Equipment LLC
• Park Avenue Medical Group, P.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.