Provider Demographics
NPI:1689828790
Name:CENTRAL PARK EAST OFFICE BASED SURGERY, P.C.
Entity Type:Organization
Organization Name:CENTRAL PARK EAST OFFICE BASED SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURO
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROMITA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-772-3220
Mailing Address - Street 1:853 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5802
Mailing Address - Country:US
Mailing Address - Phone:212-772-3220
Mailing Address - Fax:212-772-3442
Practice Address - Street 1:853 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5802
Practice Address - Country:US
Practice Address - Phone:212-772-3220
Practice Address - Fax:212-772-3442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2419OtherAAAASF