Organization
PARK AVENUE ENDOSCOPY, PLLC
Active
Other names
Wellington S. Tichenor, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WELLINGTON SHELTON TICHENOR M.D. (OWNER)
(212) 517-6611
Entity
Organization
Contact information
Practice address
642 PARK AVENUE, NEW YORK, NY 10021-6105
(212) 517-6611
(212) 517-2132
Mailing address
642 PARK AVE, NEW YORK, NY 10065-6105
(212) 517-6611
(212) 517-2132
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
NY
Other
Enumeration date
04/09/2007
Last updated
07/10/2012
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