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General NPI Number Information
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NPI Number | 1104992072
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Entity Type | Organization
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Legal Business Name | PARKMED, LLC
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 800 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10017-4709
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Country | US
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Telephone | 212-686-6402
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Fax | 212-779-7724
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Provider Business Mailing Address
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Address Line | 800 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10017-4709
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Country | US
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Telephone | 212-686-6402
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Fax | 212-779-7724
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Authorized Official
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Title or Position | FINANCIAL DIRECTOR
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Name | MR. ANN MABERRY
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Credential |
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Telephone | 212-686-6402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 261QA1903X
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License Number State | NY
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