Healthcare Provider Details

I. General information

NPI: 1821152208
Provider Name (Legal Business Name): HELEN ROUVELAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 02/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14205 ROOSEVELT AVE STE 135
FLUSHING NY
11354-6045
US

IV. Provider business mailing address

14205 ROOSEVELT AVE STE 135
FLUSHING NY
11354-6045
US

V. Phone/Fax

Practice location:
  • Phone: 718-539-1033
  • Fax: 718-535-8414
Mailing address:
  • Phone: 718-539-1033
  • Fax: 718-535-8414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number230688
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: