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

Park Avenue Medical Office, PLLC

Organization Allergy & Immunology (Internal Medicine) Physician · NPI 1013568435

Park Avenue Medical Office, PLLC is an Allergy & Immunology (Internal Medicine) Physician in New York, New York. Registered with an NPI since 2019.

In the registry since
2019
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

642 Park Ave
New York, NY 10065-6105
Phone: (212) 517-6611
Fax: (212) 517-2132
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Allergy & Immunology (Internal Medicine) Physician (primary) Taxonomy 207RA0201X

Record details

NPI number1013568435
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wellington Tichenor — Owner · (212) 517-6611
NPI enumeratedSeptember 26, 2019
Last updated in NPPESSeptember 26, 2019
Mailing address642 Park Ave, New York, NY 10065-6105

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