Organization
PARK AVENUE ENDOSCOPY, PLLC
Active
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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