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Organization

PARK AVENUE MEDICAL ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICELE LYNN VUMBICO (MEDICAL STAFF ADMINISTRATOR)
(914) 949-7900
Entity
Organization

Contact information

Practice address
3 BARKER AVE FL 4, WHITE PLAINS, NY 10601-1524
(914) 949-7900
(914) 517-2682
Mailing address
3 BARKER AVE FL 4, WHITE PLAINS, NY 10601-1524
(914) 949-7900
(914) 517-2682

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
334185
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0987186
NY
Enumeration date
02/24/2010
Last updated
02/24/2010
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