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General NPI Number Information
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NPI Number | 1720469356
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Entity Type | Organization
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Legal Business Name | ELVIS ALFONSO MD OB-GYN PC
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 06/09/2015
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Provider Practice Location Address
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Address Line | 9001 ROOSEVELT AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7938
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Country | US
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Telephone | 929-522-0165
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Fax | 929-522-0164
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Provider Business Mailing Address
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Address Line | 9001 ROOSEVELT AVE
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7938
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Country | US
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Telephone | 929-522-0165
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Fax | 929-522-0164
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Authorized Official
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Title or Position | DOCTOR
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Name | ELVIS M ALFONSO
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Credential | M.D.
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Telephone | 321-289-9287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 268246
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License Number State | NY
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