Healthcare Provider Details

I. General information

NPI: 1184074262
Provider Name (Legal Business Name): ROK MEDICAL SERVICES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 06/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 OCEAN AVE
EAST ROCKAWAY NY
11518-1208
US

IV. Provider business mailing address

510 OCEAN AVE
EAST ROCKAWAY NY
11518-1208
US

V. Phone/Fax

Practice location:
  • Phone: 516-399-2225
  • Fax: 516-399-2227
Mailing address:
  • Phone: 516-399-2225
  • Fax: 516-399-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number151257-1
License Number StateNY

VIII. Authorized Official

Name: DR. MARK CHARLES KAUFMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 516-399-2225