# 620 PARK AVENUE OBS

> 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508086570
- **Authorized official:** CARROLL LESESNE MD (PRESIDENT)
- **Authorized official phone:** (212) 570-6318

## Contact information

- **Practice address:** 620 PARK AVENUE, NEW YORK, NY 10021-0001
- **Practice address phone:** (212) 570-6318
- **Practice address fax:** (212) 988-4623
- **Mailing address:** 620 PARK AVENUE, NEW YORK, NY 10021-0001
- **Mailing address phone:** (212) 570-6318
- **Mailing address fax:** (212) 988-4623

## Taxonomy

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

## Other

- **Enumeration date:** 05/01/2007
- **Last updated:** 10/03/2007