Park 62 Oral Facial Surgery P.C.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

440777 Issued in NY

Legal business name

PARK 62 ORAL FACIAL SURGERY P.C.

Practice address

563 Park Ave
New York, NY 10065-7379

Phone

(212) 838-0090

NPI assigned

May 8, 2017

Last updated

May 8, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory Chotkowski, D.M.D.NPI 1689814915

Title

Medical Director

Phone

(212) 838-0090

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Gregory Chotkowski, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
  • NPI 1689814915
  Authorized official Same address or phone

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

{
    "created_epoch": "1494201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1518493717",
    "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": "10065"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK 62 ORAL FACIAL SURGERY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-08",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "CHOTKOWSKI",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-838-0090",
        "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": []
}

• Simon Claude Parisier, M.D.
• Pariss Medical PLLC
• Park 34 Medical Associates PC
• Park 55 Medical Associates, P.C.
• Park 56 Dental Group P.C.
• Park 62 Perio & Perio-Prosthesis PC
• Park 76 Hearing LLC
• Park Ambulatory Surgery PC
• Park Ave Maxillofacial Surgery PC
• Park Ave Pediatric Dental Office

• 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 May 8, 2017; 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.