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

Park Avenue Endocrinology & Nutrition PLLC

Organization Endocrinology, Diabetes & Metabolism Physician · NPI 1952781353

Park Avenue Endocrinology & Nutrition PLLC is an Endocrinology, Diabetes & Metabolism Physician in New York, New York. Registered with an NPI since 2015.

In the registry since
2015
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

103 E 75th St
New York, NY 10021-2805
Phone: (212) 772-7628
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Endocrinology, Diabetes & Metabolism Physician (primary) Taxonomy 207RE0101X

Record details

NPI number1952781353
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Clifton Jackness — Owner · (347) 452-3571
NPI enumeratedJune 2, 2015
Last updated in NPPESDecember 28, 2023
Certification dateDecember 28, 2023
Mailing address103 E 75th St, New York, NY 10021-2805

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