MEDICARE: ASTORIA MEDICAL SERVICES, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	209191	NY
2	207R00000X	Internal Medicine Physician	162464	NY
3	207R00000X	Internal Medicine Physician	167446	NY
4	207R00000X	Internal Medicine Physician	207431	NY
5	207RR0500X	Rheumatology Physician	237936	NY
6	207R00000X	Internal Medicine Physician	239681	NY

General Provider Information

NPI Number	:	1003048091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASTORIA MEDICAL SERVICES, PC

Provider Business Mailing Address
First Line	:	2535 31ST AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-3607
Country	:	US
Telephone Number	:	718-274-2600
Fax Number	:	718-274-5337

Provider Business Practice Location Address
First Line	:	2535 31ST AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-3607
Country	:	US
Telephone Number	:	718-274-2600
Fax Number	:	718-274-5337

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALBERTO ROZO
Credential	:	DO
Telephone Number	:	718-274-2600

Provider Enumeration Date	:	08/10/2009
Last Update Date	:	08/10/2009

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