NPIMap

Organization Active NPI

Park Avenue Facial Surgery PLLC

  • Ambulatory Surgical Clinic/Center
  • New York, NY
National Provider Identifier
1992987382
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PARK AVENUE FACIAL SURGERY PLLC
Practice address
1040 Park Ave
86TH Street
New York, NY 10028-1032
Phone
(212) 452-3362
NPI assigned
Nov 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Authorized official

Name
Joellen Gately
Title
Account Manager
Phone
(631) 732-7426

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1040 Park Ave
86TH Street
New York, NY 10028-1032

Mailing address

1040 Park Ave
86TH Street
New York, NY 10028-1032
Phone (212) 452-3362

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1992987382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 PARK AVE",
            "address_2": "86TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100281032",
            "telephone_number": "212-452-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 PARK AVE",
            "address_2": "86TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100281032",
            "telephone_number": "212-452-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE FACIAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "GATELY",
        "authorized_official_first_name": "JOELLEN",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "631-732-7426"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "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 Jul 20, 2011; 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.