Roosevelt Medical Services P C | |
6709 Roosevelt Ave 1st Floor Woodside NY 11377-2923 | |
(718) 426-9486 | |
(718) 426-9302 |
Full Name | Roosevelt Medical Services P C |
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Speciality | Internal Medicine |
Location | 6709 Roosevelt Ave, Woodside, New York |
Authorized Official Name and Position | Mario Rodrigo Haro (PRESIDENT) |
Authorized Official Contact | 7184269486 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Roosevelt Medical Services P C 6709 Roosevelt Ave 1st Floor Woodside NY 11377-2923 Ph: (718) 426-9486 | Roosevelt Medical Services P C 6709 Roosevelt Ave 1st Floor Woodside NY 11377-2923 Ph: (718) 426-9486 |
NPI Number | 1578858940 |
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Provider Enumeration Date | 06/14/2011 |
Last Update Date | 03/09/2018 |
Medicare PECOS PAC ID | 8224216809 |
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Medicare Enrollment ID | O20110630000159 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578858940 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | Mario R Haro |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1699843664 PECOS PAC ID: 2466469440 Enrollment ID: I20060316000033 |
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