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General NPI Number Information
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NPI Number | 1780030395
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Entity Type | Organization
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Legal Business Name | CENTRAL PARK AMBULATORY CARE, PLLC
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Dates
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Enumeration Date | 05/12/2016
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 36 W 44TH ST SUITE 1100
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City | NEW YORK
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State | NY
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Zip | 10036-8102
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Country | US
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Telephone | 917-639-3182
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 693
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City | NEW YORK
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State | NY
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Zip | 10013-0693
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MARTIN AZNAVOORIAN
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Credential |
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Telephone | 917-639-3182
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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 |
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License Number State |
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