Park Avenue Medical Suite

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

236558 Issued in NY

Legal business name

PARK AVENUE MEDICAL SUITE

Practice address

875 Park Ave
Suite 1F
New York, NY 10075-0382

Phone

(212) 792-6378

Fax

(212) 504-9511

NPI assigned

Oct 29, 2013

Last updated

Oct 29, 2013By 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

Dr. Constance M Chen, M.D.NPI 1083824718

Title

Director

Phone

(212) 792-6378

Specialties & licenses 1

Addresses

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.

• Constance Marian Chen, MD, MPH

  • Plastic and Reconstructive Surgery Physician
  • New York, NY
  • NPI 1083824718
  Authorized official Same address or phone

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1760810808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 PARK AVE",
            "address_2": "SUITE 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750382",
            "telephone_number": "212-792-6378",
            "fax_number": "212-504-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 PARK AVE",
            "address_2": "SUITE 1F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750382",
            "telephone_number": "212-792-6378",
            "fax_number": "212-504-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE MEDICAL SUITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "212-792-6378",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "236558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Avenue Medical Imaging and Mommography
• Park Avenue Medical Imaging PC
• Park Avenue Medical Office, PLLC
• Park Avenue Medical PLLC
• Park Avenue Medical Professionals
• Park Avenue Medical Weight and Wellness P.C.
• Park Avenue Medicl Associates P.L.L.C
• Park Avenue OB/GYN P.C
• Park Avenue Obs
• Park Avenue Office Based Podiatric Surgery 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 Oct 29, 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.