Organization
PARK AVENUE EYE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TILLIE ANDRADE (CREDENTIALING SPECIALIST)
(702) 449-9173
Entity
Organization
Contact information
Practice address
110 E 60TH ST, STE 602, NEW YORK, NY 10022-1811
(212) 808-4888
Mailing address
110 E 60TH ST, STE 602, NEW YORK, NY 10022-1811
(212) 808-4888
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
—
Other
Enumeration date
08/15/2025
Last updated
10/15/2025
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