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General NPI Number Information
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NPI Number | 1235319815
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Entity Type | Organization
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Legal Business Name | PARK AVENUE MATERNAL-FETAL MEDICINE PLLC
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 523 E 72ND ST FL 9 ATTN: KEITH B LESCALE MD
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City | NEW YORK
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State | NY
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Zip | 10021-4099
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Country | US
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Telephone | 212-249-1788
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Fax |
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Provider Business Mailing Address
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Address Line | 523 E 72ND ST FL 9 ATTN: KEITH B LESCALE MD
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City | NEW YORK
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State | NY
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Zip | 10021-4099
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Country | US
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Telephone | 212-249-1788
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. HENRIQUE PARAIZO
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Credential |
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Telephone | 212-249-1788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 186070
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License Number State | NY
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