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General NPI Number Information
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NPI Number | 1003805219
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Entity Type | Organization
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Legal Business Name | PARK AVENUE MEDICAL PLLC
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 451 PARK AVE S FLOOR 2
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City | NEW YORK
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State | NY
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Zip | 10016-7390
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Country | US
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Telephone | 212-779-0202
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Fax | 212-779-1521
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Provider Business Mailing Address
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Address Line | 451 PARK AVE S FLOOR 2
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City | NEW YORK
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State | NY
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Zip | 10016-7390
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Country | US
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Telephone | 212-779-0202
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Fax | 212-779-1521
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | DR. JOSE ROLANDO SANCHEZ-PEA
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Credential | MD
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Telephone | 212-779-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 202594
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 202594
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 202594
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 202594
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 213773
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 158015
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 136143
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License Number State | NY
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Taxonomy #8
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 158015
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License Number State | NY
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Taxonomy #9
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 158015
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License Number State | NY
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Taxonomy #10
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 213773
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License Number State | NY
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