Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Oral Reconstructive Jaw Surgery PC

Organization Specialist · NPI 1356733224

Oral Reconstructive Jaw Surgery PC provides Specialist services in New York, New York. Licensed in New York. Registered with an NPI since 2015.

Licensed in
NY
In the registry since
2015
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

563 Park Ave
New York, NY 10065-7379 Not confirmed with CMS for 11 years — call before visiting
Phone: (212) 838-0090
Fax: (212) 935-1296
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 440777 (NY)

Record details

NPI number1356733224
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gregory Chotkowki — Medical Director · (212) 838-0090
NPI enumeratedMarch 2, 2015
Last updated in NPPESMarch 2, 2015
Mailing address563 Park Ave, New York, NY 10065-7379

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