| NPI | 1740546399 |
|---|---|
| Former Legal Business Name | PARK AVENUE MEDICAL LLC |
| Entity Type | Organization |
| Authorized Contact | ANACE SAID Business Owner 203-309-0070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 044791) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2022-06-20 |