620 Park Avenue Obs

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

620 PARK AVENUE OBS

Practice address

620 Park Avenue
New York, NY 10021-0001

Phone

(212) 570-6318

Fax

(212) 988-4623

NPI assigned

May 1, 2007

Organization subpart

No

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

Authorized official

Name

Carroll Lesesne, MD

Title

President

Phone

(212) 570-6318

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1508086570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 PARK AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210001",
            "telephone_number": "212-570-6318",
            "fax_number": "212-988-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 PARK AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210001",
            "telephone_number": "212-570-6318",
            "fax_number": "212-988-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "620 PARK AVENUE OBS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "LESESNE",
        "authorized_official_first_name": "CARROLL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-570-6318",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.