MEDICARE: AESTHETICS & PLASTIC SURGERY OF PARK AVE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1417155565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AESTHETICS & PLASTIC SURGERY OF PARK AVE PLLC

Provider Business Mailing Address
First Line	:	200 LA BONNE VIE DR
Second Line	:	C/O DARCY MANAGEMENT OFFICE
City	:	EAST PATCHOGUE
State	:	NY
Zip	:	11772-4434
Country	:	US
Telephone Number	:	631-289-4400
Fax Number	:	631-289-4403

Provider Business Practice Location Address
First Line	:	655 PARK AVE
Second Line	:	SUITE NETC
City	:	NEW YORK
State	:	NY
Zip	:	10065-5937
Country	:	US
Telephone Number	:	212-794-3900
Fax Number	:	212-794-0760

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. SCOTT BRIAN WELLS
Credential	:	M.D.
Telephone Number	:	212-794-3900

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	07/10/2007

Similar Medicare Providers

1346221660 — JUDITH HERTANU MD
Practice Location Address:

10 UNION SQ E , BETH ISRAEL MED CTR- DEPT OF REHAB MEDICARE
NEW YORK, NY
10003-3314

Practice Phone: 212-420-2757
Practice Fax:

1457603086 — DR. MICHAEL JOSEPH FEDAK M.D.
Practice Location Address:

655 PARK AVE
NEW YORK, NY
10065-5937

Practice Phone: 212-396-2888
Practice Fax:

1427302397 — MELISSA A. DOFT MD PLLC
Practice Location Address:

655 PARK AVE
NEW YORK, NY
10065-5937

Practice Phone: 212-600-4109
Practice Fax: 917-591-9090

1124461447 — DR. ANDREW L. WEINSTEIN M.D.
Practice Location Address:

655 PARK AVE
NEW YORK, NY
10065-5937

Practice Phone: 212-517-9777
Practice Fax: 212-517-9777

1851009971 — ANDREW L. WEINSTEIN MD, PLLC
Practice Location Address:

655 PARK AVE
NEW YORK, NY
10065-5937

Practice Phone: 212-517-9777
Practice Fax: 914-206-4144

1750309829 — DAVID HIDALGO MD, PC
Practice Location Address:

655 PARK AVE
NEW YORK, NY
10021-5937

Practice Phone: 212-517-9777
Practice Fax:

Directions to “AESTHETICS & PLASTIC SURGERY OF PARK AVE PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.