# PARK AVENUE AMBULATORY MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ATLANTIC SPINE CENTER LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1609265016
- **Legal business name:** ATLANTIC SPINE CENTER LLC
- **Authorized official:** DR. KAIXUAN LIU MD (PRESIDENT)
- **Authorized official phone:** (973) 419-0200

## Contact information

- **Practice address:** 1045 PARK AVE, NEW YORK, NY 10028-1030
- **Practice address phone:** (973) 419-0200
- **Practice address fax:** (973) 419-0244
- **Mailing address:** 1045 PARK AVE, NEW YORK, NY 10028-1030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2205381 | NY | Yes |

## Other

- **Enumeration date:** 01/22/2015
- **Last updated:** 10/15/2015