Healthcare Provider Details

I. General information

NPI: 1356453393
Provider Name (Legal Business Name): PARK AVENUE ORTHOTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E 55TH ST FL 7TH
NEW YORK NY
10022-4514
US

IV. Provider business mailing address

150 E 55TH ST FL 7TH
NEW YORK NY
10022-4514
US

V. Phone/Fax

Practice location:
  • Phone: 212-297-0362
  • Fax: 212-697-3697
Mailing address:
  • Phone: 212-297-0362
  • Fax: 212-697-3697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0903196
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberCZ1985
License Number StateMD

VIII. Authorized Official

Name: MR. HOWARD GOLDSCHEIN
Title or Position: PRESIDENT
Credential:
Phone: 212-297-0362