Provider Demographics
NPI:1295958437
Name:PARK AVENUE PODIATRY ASSOCIATES PC
Entity type:Organization
Organization Name:PARK AVENUE PODIATRY ASSOCIATES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:R
Authorized Official - Last Name:LURIE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-753-3520
Mailing Address - Street 1:133 EAST 58TH STREET
Mailing Address - Street 2:SUITE 407
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1236
Mailing Address - Country:US
Mailing Address - Phone:212-753-3520
Mailing Address - Fax:212-753-3521
Practice Address - Street 1:133 EAST 58TH STREET
Practice Address - Street 2:SUITE 407
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1236
Practice Address - Country:US
Practice Address - Phone:212-753-3520
Practice Address - Fax:212-753-3521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006052213E00000X
NYN003793213E00000X
NYN003765213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty