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General NPI Number Information
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NPI Number | 1962951665
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Entity Type | Organization
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Legal Business Name | 737 PARK AVENUE SURGERY SUITE, P.C.
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 737 PARK AVE UNIT D
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City | NEW YORK
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State | NY
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Zip | 10021-4243
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Country | US
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Telephone | 212-229-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 737 PARK AVE UNIT D
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City | NEW YORK
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State | NY
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Zip | 10021-4243
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Country | US
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Telephone | 212-229-1100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EDWARD KWAK
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Credential | M.D.
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Telephone | 212-229-1100
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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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