PARK 62 PERIO & PERIO-PROSTHESIS PC (NPI# 1740737758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740737758 |
| Entity Type | Organization |
| Organization Name | PARK 62 PERIO & PERIO-PROSTHESIS PC |
| Practice Address |
563 Park Ave New York NY 10065-7379 |
| Practice Telephone | 2128380090 |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |
| Authorized Official Name | PASQUALE MALPESO (PRESIDENT) |
| Authorized Official Telephone | 2128380090 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 440777 | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | THE JOINT COMMISSION | 440777 | 01 |
| Street Address |
563 PARK AVE |
| City | NEW YORK |
| State | NY |
| Zip Code | 10065-7379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073647772 | Pasquale J Malpeso | Dentist | 563 Park Ave, New York, NY 10021-7314 | 2007-03-15 |
| 1740755487 | Upper East Midtown Periodontics PC | Clinic/Center | 563 Park Ave, New York, NY 10065-7379 | 2018-10-09 |
| 1972016988 | Park Ave Maxillofacial Surgery PC | Clinic/Center | 563 Park Ave, New York, NY 10065-7379 | 2017-11-13 |
| 1518493717 | Park 62 Oral Facial Surgery P.C. | Clinic/Center | 563 Park Ave, New York, NY 10065-7379 | 2017-05-08 |
| 1275071318 | Maxillofacial Surgery of Ny PC | Clinic/Center | 563 Park Ave, New York, NY 10065-7379 | 2017-02-09 |
| 1053771162 | G Chotkowski Dmd PC | Dentist | 563 Park Ave, New York, NY 10065-7379 | 2016-03-02 |
| 1124499066 | Oral Facial Surgery On Park PC | Specialist | 563 Park Ave, New York, NY 10065-7379 | 2015-10-19 |
| 1356733224 | Oral Reconstructive Jaw Surgery PC | Specialist | 563 Park Ave, New York, NY 10065-7379 | 2015-03-02 |
| 1407244619 | Gregory C. Chotkowski Dmd PC | Dentist | 563 Park Ave, New York, NY 10065-7379 | 2014-12-23 |
| 1235532870 | Park Avenue Maxillary & Mandibular Restorations PC | Clinic/Center | 563 Park Ave, New York, NY 10065-7379 | 2014-09-26 |
| Find all providers in the same location | ||||
| 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 Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275148652 | Gloria Li | Specialist | 959 1st Ave, New York, NY 10022-6649 | 2020-09-11 |
| 1700495041 | Ana Rosa Perez | Specialist | 318 E 116th St, New York, NY 10029-1506 | 2020-07-22 |
| 1659995801 | Theodore Nathan Raosen | Specialist | 128 Pinehurst Ave Apt B61, New York, NY 10033-1755 | 2020-06-03 |
| 1255954301 | Courtney Foster | Specialist | 222 E 34th St # 13, New York, NY 10016-4842 | 2020-05-23 |
| 1396371852 | Laquanique Louise Lake | Specialist | 116west 32nd Street, New York, NY 10001-3212 | 2020-03-17 |
| 1205460524 | Yasmin El-hifnawi Cooper | Specialist | 2572 Frederick Douglass Blvd Unit B, New York, NY 10030-2106 | 2020-02-25 |
| 1376175992 | Patricia Ann Ebert | Specialist | 310 E 102nd St Apt 9d, New York, NY 10029-5607 | 2020-02-11 |
| 1912547928 | Roberto Manuel Gonzalez | Specialist | 250 W 108th St, New York, NY 10025-2956 | 2020-01-08 |
| 1659918639 | Delores Cody Oppecker | Specialist | 455 Fort Washington Ave Apt 53, New York, NY 10033-4631 | 2019-12-09 |
| 1174160543 | Jazmin Bernal | Specialist | 765 Riverside Dr, 3n, New York, NY 10032 | 2019-12-04 |
| Find all providers in NEW YORK | ||||
Please comment or provide details below to improve the information on PARK 62 PERIO & PERIO-PROSTHESIS PC.
| 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.