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NPI Code Detail

MEDICARE: QLIMG - ROCKAWAY MED OFFICE

MEDICARE: QLIMG - ROCKAWAY MED OFFICE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207K00000XAllergy & Immunology Physician
2207Q00000XFamily Medicine Physician
3207R00000XInternal Medicine Physician
4207RH0003XHematology & Oncology Physician
5207RP1001XPulmonary Disease Physician
6207RR0500XRheumatology Physician
7207V00000XObstetrics & Gynecology Physician
8207W00000XOphthalmology Physician
9207X00000XOrthopaedic Surgery Physician
10208000000XPediatrics Physician
112080P0201XPediatric Allergy/Immunology Physician
122080P0205XPediatric Endocrinology Physician
13208600000XSurgery Physician
14208800000XUrology Physician
15213E00000XPodiatrist

General Provider Information

NPI Number : 1063592764
Entity Type Code : Organization
Provider Name (Legal Business Name) : QLIMG - ROCKAWAY MED OFFICE
Provider Business Mailing Address
First Line : 2915 FAR ROCKAWAY BLVD
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-1941
Country : US
Telephone Number : 718-337-7000
Fax Number : 718-327-8897
Provider Business Practice Location Address
First Line : 2915 FAR ROCKAWAY BLVD
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-1941
Country : US
Telephone Number : 718-337-7000
Fax Number : 718-327-8897
Authorized Official
Title or Position : DIRECTOR, CREDENTIALING
Name : MARLENA SIMPSON
Credential :
Telephone Number : 516-542-6880
Provider Enumeration Date : 10/17/2006
Last Update Date : 09/11/2025

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Directions to “QLIMG - ROCKAWAY MED OFFICE ” Practice Location

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