PARK AVENUE MEDICAL OFFICE, PLLC


Address: 642 Park Ave, New York, NY 10065-6105
Phone: 2125176611

PARK AVENUE MEDICAL OFFICE, PLLC (NPI# 1013568435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013568435
Entity Type Organization
Organization Name PARK AVENUE MEDICAL OFFICE, PLLC
Practice Address 642 Park Ave
New York
NY 10065-6105
Practice Telephone 2125176611
Practice Fax Number 2125172132
Mailing Telephone 2125176611
Mailing Fax Number 2125172132
Enumeration Date 2019-09-26
Last Update Date 2019-09-26
Authorized Official Name DR. WELLINGTON S TICHENOR (OWNER)
Authorized Official Telephone 2125176611
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RA0201X Internal Medicine
Specialization: Allergy & Immunology
Allopathic & Osteopathic Physicians

Office Location

Street Address 642 PARK AVE
City NEW YORK
State NY
Zip Code 10065-6105

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508871450 Wellington Shelton Tichenor Allergy & Immunology 642 Park Ave, New York, NY 10021-6105 2006-07-29
1821413246 Mary Youch Nurse Practitioner 642 Park Ave, New York, NY 10065-6105 2014-02-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699372706 Anna Jane Dare Student in an Organized Health Care Education/Training Program 1275 York Avenue Department of Surgery, Memorial Sloan, Kettering Cancer Center, New York, NY 10065 2020-10-02
1609480987 Kimberly Ann Oppenheim Physician Assistant 525 E. 68th Street. Box# 325, Inpatient Oncology Pa Service, New York, NY 10065 2020-09-03
1043829252 Bridget Maginity Physician Assistant 1283 York Ave 14th Floor, New York, NY 10065 2020-07-24
1154948016 Andrew Timothy Mclean Student in an Organized Health Care Education/Training Program Memorial Sloan Kettering Cancer Centre, 1275 York Ave, New York, NY 10065 2020-06-26
1972128700 Seeminder Brar Anesthesiology Weill Cornell Medicine - Department of Anesthesiology, 525 East 68th Street, New York, NY 10065 2020-06-08
1114548245 Mohamed Medhat Soliman Student in an Organized Health Care Education/Training Program 525 East 68th Street, Room F734, New York-presbyterian Hospital/weill Cornell Medical Ce, Manhattan, NY 10065 2020-04-29
1700417672 Carlos Henrique Dos Anjos Internal Medicine 300 E 66th St, New York, Ny, New York, NY 10065 2020-01-30
1134788557 Marvin Herbert Braun Student in an Organized Health Care Education/Training Program Department of Neurology, Sixth Floor, Weill Cornell Med, 525 East 68 St., New York, NY 10065 2019-06-10
1356907356 Andrew Garton Student in an Organized Health Care Education/Training Program New York Weill Cornell Medical Center, 525 E 68th St, New York, NY 10065 2019-05-15
1104481845 Rana Abualsaud Student in an Organized Health Care Education/Training Program New York Presbyterian Hospital, 525 E 68th St, Room M130, New York City, NY 10065 2019-05-08
Find all providers in zip 10065

Taxonomy Information

Taxonomy Code 207RA0201X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Allergy & Immunology

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1306176730 Bernard Benjamin Levine Internal Medicine 210 Riverside Dr, 9f, New York, NY 10025-6802 2010-01-07
1538227905 Arthur Englard Internal Medicine 2 West 67th Street, New York, NY 10023 2006-12-05
1114311792 Nicole Ramsey Internal Medicine 1 Gustave L Levy Pl, New York, NY 10029-6504 2015-03-23
1053467886 Elizabeth Jacobson Internal Medicine 425 E 61st St, 11th Floor, New York, NY 10065-8722 2007-01-26
1720144009 Barton Inkeles Internal Medicine 903 Lexington Ave, New York, NY 10021-5902 2006-12-29
1659399483 Beth E Corn Internal Medicine 5 East 98th Street, Mount Sinai Medical Center, New York, NY 10029 2006-07-18
1134147937 Paula J Busse Internal Medicine 5 East 98th Street, New York, NY 10029 2006-07-18
1619906427 Charlotte Cunningham-rundles Internal Medicine 5 E 98th St, New York, NY 10029-6501 2006-07-02
1346297496 Midtown Internal Medicine Pllc Internal Medicine 133 E 58th St, Suite 301, New York, NY 10022-1236 2006-05-27
1184623134 Roger Ira Emert Internal Medicine 80 5th Ave, Suite 1601, New York, NY 10011-8002 2005-07-20
Find all providers in NEW YORK

Competitor

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City NEW YORK
Zip Code 10065

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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