MEDICARE: ROCKAWAY INTERNAL MEDICINE PLLC

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	207R00000X	Internal Medicine Physician	241306	NY

General Provider Information

NPI Number	:	1669774527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKAWAY INTERNAL MEDICINE PLLC

Provider Business Mailing Address
First Line	:	14712 ROCKAWAY BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11436-1634
Country	:	US
Telephone Number	:	718-832-8844
Fax Number	:

Provider Business Practice Location Address
First Line	:	14712 ROCKAWAY BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11436-1634
Country	:	US
Telephone Number	:	718-832-8844
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SHIVA SHAMTOUB
Credential	:
Telephone Number	:	718-732-7744

Provider Enumeration Date	:	11/29/2010
Last Update Date	:	03/16/2011

Similar Medicare Providers

1366586646 — DR. SHIVA SHAMTOUB DO
Practice Location Address:

14712 ROCKAWAY BLVD
JAMAICA, NY
11436-1634

Practice Phone: 718-732-7744
Practice Fax: 347-644-1745

1316212897 — ROCKAWAY FAMILY DENTISTRY PLLC
Practice Location Address:

14712 ROCKAWAY BLVD
JAMAICA, NY
11436-1634

Practice Phone: 718-732-7744
Practice Fax: 347-644-1745

1306055066 — PARAMOUNT SECURITY BUREAU, INC. DBAPSB HOME CARE AGENCY
Practice Location Address:

12814 149TH ST
JAMAICA, NY
11436-1920

Practice Phone: 718-659-6764
Practice Fax: 718-659-6760

1740484930 — MS. SUSAN LARAE FORBES
Practice Location Address:

11418 149TH ST
JAMAICA, NY
11436-1120

Practice Phone: 347-239-4610
Practice Fax:

1811180581 — SPEAK EASY SPEECH SERVICES
Practice Location Address:

11435 140TH ST
JAMAICA, NY
11436-1016

Practice Phone: 917-715-0764
Practice Fax: 718-659-8765

1316127293 — HARINARINE MATHURA PA
Practice Location Address:

11616 143RD ST
JAMAICA, NY
11436-1241

Practice Phone: 718-374-3382
Practice Fax:

Directions to “ROCKAWAY INTERNAL MEDICINE PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.