Park Ave Reconstructive LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PARK AVE RECONSTRUCTIVE LLC

Practice address

461 Park Ave South Ste 7a
New York, NY 10016-8403

Phone

(212) 481-3939

Fax

(212) 688-6602

NPI assigned

Mar 30, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Senderoff, MD

Title

President

Phone

(212) 481-3939

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1679968499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 PARK AVE SOUTH STE 7A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168403",
            "telephone_number": "212-481-3939",
            "fax_number": "212-688-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 PARK AVE SOUTH STE 7A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168403",
            "telephone_number": "212-481-3939",
            "fax_number": "212-688-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVE RECONSTRUCTIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "SENDEROFF",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-481-3939",
        "authorized_official_name_prefix": "Dr.",
        "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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• 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 Mar 30, 2015; 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.