# AESTHETICS & PLASTIC SURGERY OF PARK AVE PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Park Avenue Plastic Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417155565
- **Authorized official:** DR. SCOTT BRIAN WELLS M.D. (DIRECTOR)
- **Authorized official phone:** (212) 794-3900

## Contact information

- **Practice address:** 655 PARK AVE, SUITE NETC, NEW YORK, NY 10065-5937
- **Practice address phone:** (212) 794-3900
- **Practice address fax:** (212) 794-0760
- **Mailing address:** 200 LA BONNE VIE DR, C/O DARCY MANAGEMENT OFFICE, EAST PATCHOGUE, NY 11772-4434
- **Mailing address phone:** (631) 289-4400
- **Mailing address fax:** (631) 289-4403

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/10/2007
- **Last updated:** 07/10/2007