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General NPI Number Information
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NPI Number | 1356453393
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Entity Type | Organization
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Legal Business Name | PARK AVENUE ORTHOTICS, INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 155 E 55TH ST STE 200
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City | NEW YORK
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State | NY
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Zip | 10022-4051
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Country | US
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Telephone | 212-297-0362
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Fax | 212-697-3697
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Provider Business Mailing Address
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Address Line | 155 E 55TH ST STE 200
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City | NEW YORK
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State | NY
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Zip | 10022-4051
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Country | US
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Telephone | 212-297-0362
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Fax | 212-697-3697
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HOWARD GOLDSCHEIN
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Credential |
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Telephone | 212-297-0362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | CZ1985
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0903196
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License Number State | NY
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