Provider Demographics
NPI:1457785768
Name:PARK AVENUE SPECIALTY CARE OFFICE BASED PLASTIC SURGERY, PLLC
Entity type:Organization
Organization Name:PARK AVENUE SPECIALTY CARE OFFICE BASED PLASTIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:MARLON
Authorized Official - Last Name:MONASEBIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-472-8700
Mailing Address - Street 1:950 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0320
Mailing Address - Country:US
Mailing Address - Phone:212-472-8700
Mailing Address - Fax:212-472-2014
Practice Address - Street 1:950 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0320
Practice Address - Country:US
Practice Address - Phone:212-472-8700
Practice Address - Fax:212-472-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-23
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty