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General NPI Number Information
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NPI Number | 1023063484
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Entity Type | Organization
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Legal Business Name | TOTAL HEALTH MEDICAL SERVICES, P.C.
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 9511 JAMAICA AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421-2224
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Country | US
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Telephone | 718-846-7500
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Fax | 718-846-7507
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Provider Business Mailing Address
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Address Line | 3778 ILLONA LN
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City | OCEANSIDE
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State | NY
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Zip | 11572-5973
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Country | US
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Telephone | 718-634-7000
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Fax | 718-634-7000
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Authorized Official
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Title or Position | DOCTOR
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Name | AFSHIN GHOLOMHASSANI
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Credential | M.D.
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Telephone | 718-634-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 218325
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License Number State | NY
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