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Organization
PARK AVENUE AESTHETIC SURGERY, PC
Active
Organization
PARK AVENUE AESTHETIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT DALLMANN (BILLING MANAGER)
(212) 206-6465
Entity
Organization
Contact information
Practice address
461 PARK AVE S FL 7, NEW YORK, NY 10016-6822
(212) 206-6465
(212) 255-2132
Mailing address
461 PARK AVE S FL 7, NEW YORK, NY 10016-6822
(212) 206-6465
(212) 255-2132
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
183561
NY
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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