NPIMap

Organization Active NPI

Park Avenue Aesthetic Surgery, PC

  • Specialist
  • New York, NY
National Provider Identifier
1669818324
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
183561 Issued in NY
Legal business name
PARK AVENUE AESTHETIC SURGERY, PC
Practice address
461 Park Ave S FL 7
New York, NY 10016-6822
Phone
(212) 206-6465
Fax
(212) 255-2132
NPI assigned
May 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Authorized official

Name
Mr. Matt Dallmann
Title
Billing Manager
Phone
(212) 206-6465

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 183561 NY Primary

Addresses

Primary practice location

461 Park Ave S FL 7
New York, NY 10016-6822

Mailing address

461 Park Ave S FL 7
New York, NY 10016-6822
Phone (212) 206-6465

National Provider Directory

National Provider Directory

Locations

461 Park Ave S
Fl 7
New York, NY 10016
Phone (212) 206-6465

461 Park Ave S
Fl 7A
New York, NY 10016

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1669818324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 PARK AVE S FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166822",
            "telephone_number": "212-206-6465",
            "fax_number": "212-255-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 PARK AVE S FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166822",
            "telephone_number": "212-206-6465",
            "fax_number": "212-255-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE AESTHETIC SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "DALLMANN",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "212-206-6465",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "183561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.