Healthcare Provider Details

I. General information

NPI: 1861855397
Provider Name (Legal Business Name): QUEENS MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7514 37TH AVE STE A
JACKSON HEIGHTS NY
11372-6538
US

IV. Provider business mailing address

7514 37TH AVE STE A
JACKSON HEIGHTS NY
11372-6538
US

V. Phone/Fax

Practice location:
  • Phone: 718-433-9333
  • Fax: 718-433-9445
Mailing address:
  • Phone: 718-433-9333
  • Fax: 718-433-9445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number240621
License Number StateNY

VIII. Authorized Official

Name: ALVARO ALFONSO OLAYO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 607-331-4511