OrganizationActive
Aesthetics & Plastic Surgery of Park Ave PLLC
NPI 1417155565 · Ambulatory Surgical Clinic/Center · New York, NY
Provider details
- NPI number
- 1417155565
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Scott Wells, Director(212) 794-3900
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
655 Park Ave
Suite Netc
New York, NY 10065-5937
Phone: (212) 794-3900
Fax: (212) 794-0760
Street-level locationGet directions
Mailing address
200 La Bonne Vie Dr
East Patchogue, NY 11772-4434
Other names (DBA / former)
- Doing business as
- Park Avenue Plastic Surgery Center
Registry dates
- Enumerated
- 2007-07-10
- Last updated
- 2007-07-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.