NPIMap

Organization Active NPI

Park Avenue Medical Associates

  • Skilled Nursing Facility
  • Greenwich, CT
National Provider Identifier
1992065007
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
073864 Issued in CT
Legal business name
PARK AVENUE MEDICAL ASSOCIATES
Practice address
17 Woods Ave
Greenwich, CT 06831-3633
Phone
(917) 337-5804
NPI assigned
May 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Authorized official

Name
Mr. Eric Dowd
Title
Credentialing Coordinator
Phone
(914) 949-7900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 073864 CT Primary

Addresses

Primary practice location

17 Woods Ave
Greenwich, CT 06831-3633

Mailing address

17 Woods Ave
Greenwich, CT 06831-3633
Phone (917) 337-5804

National Provider Directory

National Provider Directory
Tax ID family
Park Avenue Medical Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1992065007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WOODS AVE",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068313633",
            "telephone_number": "917-337-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WOODS AVE",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068313633",
            "telephone_number": "917-337-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "DOWD",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "914-949-7900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "073864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.