Provider Demographics
NPI:1922871417
Name:PARK AVENUE ORAL, MAXILLOFACIAL, IMPLANT SURGERY, PLLC
Entity Type:Organization
Organization Name:PARK AVENUE ORAL, MAXILLOFACIAL, IMPLANT SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DMD, FACS
Authorized Official - Phone:917-270-9950
Mailing Address - Street 1:226 50TH AVE APT 11D
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4523
Mailing Address - Country:US
Mailing Address - Phone:917-270-9950
Mailing Address - Fax:
Practice Address - Street 1:121 E 60TH ST
Practice Address - Street 2:SUITE 7A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1198
Practice Address - Country:US
Practice Address - Phone:212-339-3930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery