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Organization
PARK 62 ORAL FACIAL SURGERY P.C.
Active
Organization
PARK 62 ORAL FACIAL SURGERY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY CHOTKOWSKI D.M.D. (MEDICAL DIRECTOR)
(212) 838-0090
Entity
Organization
Contact information
Practice address
563 PARK AVE, NEW YORK, NY 10065-7379
(212) 838-0090
Mailing address
563 PARK AVE., NEW YORK, NY 10065
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
440777
NY
Other
Enumeration date
05/08/2017
Last updated
05/08/2017
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