Park Ave Maxillofacial Surgery PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

440777 Issued in NY

Legal business name

PARK AVE MAXILLOFACIAL SURGERY PC

Practice address

563 Park Ave
New York, NY 10065-7379

Phone

(212) 838-0090

NPI assigned

Nov 13, 2017

Organization subpart

No

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

Authorized official

Name

Gregory Chokowski, DMD

Title

Medical Director

Phone

(212) 838-0090

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510531200000",
    "number": "1972016988",
    "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": "212-838-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVE MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A",
        "authorized_official_last_name": "CHOKOWSKI",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-838-0090",
        "authorized_official_credential": "DMD"
    },
    "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": []
}

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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 Nov 13, 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.