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ROOSEVELT MEDICAL SERVICES P C NPI 1578858940


NPI Information

NPI: 1578858940
Provider Name: ROOSEVELT MEDICAL SERVICES P C
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 33D0999155

Address:
6709 ROOSEVELT AVE
1ST FLOOR
WOODSIDE, NY
ZIP 11377
Phone: (718) 426-9486
Get Directions

ROOSEVELT MEDICAL SERVICES P C is a geriatric medicine internal medicine in Woodside, NY. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. ROOSEVELT MEDICAL SERVICES P C NPI is 1578858940. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6709 ROOSEVELT AVE
1ST FLOOR
WOODSIDE, NY
ZIP 11377-923
Phone: (718) 426-9486
Fax: (718) 426-9302

The provider's authorized official is Mario Rodrigo Haro .
The authorized official title is President and has the following contact phone number (718) 426-9486.

The CLIA number assigned to this NPI record is 33D0999155 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/14/2011 and was last updated on 3/9/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0300XInternal MedicineGeriatric MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.