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1013568435
PARK AVENUE MEDICAL OFFICE, PLLC
NEW YORK, NY
NPI
1013568435
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Entity Type
Organization
Authorized Contact
WELLINGTON S TICHENOR
Owner
212-517-6611
Organization Subpart ?
No
Primary Taxonomy
207RA0201X Internal Medicine, Allergy & Immunology
Enumeration Date
2019-09-26
Last Update Date
2019-09-26
Business Address
PARK AVENUE MEDICAL OFFICE, PLLC
642 PARK AVE
NEW YORK, NY 10065-6105
Phone number: 212-517-6611
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Mailing Address
PARK AVENUE MEDICAL OFFICE, PLLC
642 PARK AVE
NEW YORK, NY 10065-6105
Phone number: 212-517-6611
Copy
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