| Organization Name: | PARK AVENUE FACIAL AND RECONSTRUCTIVE SURGERY, PLLC |
| NPI Number: | 1003041583 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEVEN J. PEARLMAN (DIRECTOR/OWNER) |
| Mailing Address: | 521 Park Ave New York |
| State: | NY US |
| Postal Code: | 100658195 |
| Phone Number: | 2122238300 |
| Fax Number: | 2126448655 |
| NPI Enumeration Date: | 05/27/2009 |
| NPI Last Update Date: | 05/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 156744 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |