Provider Demographics
NPI:1235319815
Name:PARK AVENUE MATERNAL-FETAL MEDICINE PLLC
Entity Type:Organization
Organization Name:PARK AVENUE MATERNAL-FETAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARAIZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-249-1788
Mailing Address - Street 1:523 E 72ND ST FL 9
Mailing Address - Street 2:ATTN: KEITH B LESCALE MD
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4099
Mailing Address - Country:US
Mailing Address - Phone:212-249-1788
Mailing Address - Fax:
Practice Address - Street 1:523 E 72ND ST FL 9
Practice Address - Street 2:ATTN: KEITH B LESCALE MD
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4099
Practice Address - Country:US
Practice Address - Phone:212-249-1788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186070207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty