| Rockaway Internal Medicine Pllc | |
|
14712 Rockaway Blvd Jamaica NY 11436-1634 | |
| (718) 832-8844 | |
| Not Available |
| Full Name | Rockaway Internal Medicine Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 14712 Rockaway Blvd, Jamaica, New York |
| Authorized Official Name and Position | Shiva Shamtoub (PRESIDENT) |
| Authorized Official Contact | 7187327744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rockaway Internal Medicine Pllc 14712 Rockaway Blvd Jamaica NY 11436-1634 Ph: (718) 832-8844 | Rockaway Internal Medicine Pllc 14712 Rockaway Blvd Jamaica NY 11436-1634 Ph: (718) 832-8844 |
| NPI Number | 1669774527 |
|---|---|
| Provider Enumeration Date | 11/29/2010 |
| Last Update Date | 03/16/2011 |
| Medicare PECOS PAC ID | 7810170537 |
|---|---|
| Medicare Enrollment ID | O20110317000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669774527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 241306 (New York) | Primary |
| Provider Name | Shiva Shamtoub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366586646 PECOS PAC ID: 4385747542 Enrollment ID: I20070309000083 |
| Provider Name | Arash Shifteh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154622421 PECOS PAC ID: 0446429724 Enrollment ID: I20110802000450 |
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