Park Avenue Perio-Prosthesis PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

#440777 Issued in NY

Legal business name

PARK AVENUE PERIO-PROSTHESIS PC

Practice address

563 Park Ave
New York, NY 10065-7379

Phone

(212) 838-0383

NPI assigned

Aug 14, 2013

Organization subpart

No

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

Authorized official

Name

Pasquale J Malpeso, D.M.D.

Title

President

Phone

(212) 838-0383

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1568895464",
    "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 PERIO-PROSTHESIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-14",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "MALPESO",
        "authorized_official_first_name": "PASQUALE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-838-0383",
        "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": "ID# 440777",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Park Avenue Oral, Maxillofacial, Implant Surgery, PLLC
• Park Avenue Orthodontics
• Park Avenue Orthopaedics,P.C.
• Park Avenue Orthotics, Inc.
• Park Avenue Pediatrics of Manhattan, PC
• Park Avenue Periodontal Prosthesis Obs Facility
• Park Avenue Physical Therapy & Rehabilitation PLLC
• Park Avenue Physical Therapy Services, PLLC
• Park Avenue Physicians New York PLLC
• Park Avenue Physicians PC

• 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 Aug 14, 2013; 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.