Healthcare Provider Details

I. General information

NPI: 1003048091
Provider Name (Legal Business Name): ASTORIA MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 31ST AVE
LONG ISLAND CITY NY
11106-3607
US

IV. Provider business mailing address

2535 31ST AVE
LONG ISLAND CITY NY
11106-3607
US

V. Phone/Fax

Practice location:
  • Phone: 718-274-2600
  • Fax: 718-274-5337
Mailing address:
  • Phone: 718-274-2600
  • Fax: 718-274-5337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number209191
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number162464
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number167446
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number207431
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number237936
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number239681
License Number StateNY

VIII. Authorized Official

Name: ALBERTO ROZO
Title or Position: PRESIDENT
Credential: DO
Phone: 718-274-2600