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Organization
969 PARK SURGICAL SUITE PLLC
Active
Organization
969 PARK SURGICAL SUITE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVIVA PREMINGER MD (MEDICAL DIRECTOR)
(212) 706-1900
Entity
Organization
Contact information
Practice address
969 PARK AVE STE 1F, NEW YORK, NY 10028-0322
(917) 382-4544
Mailing address
969 PARK AVE STE 1F, NEW YORK, NY 10028-0322
(999) 999-9999
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/13/2025
Last updated
03/18/2026
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