Provider Demographics
NPI:1003048091
Name:ASTORIA MEDICAL SERVICES, PC
Entity Type:Organization
Organization Name:ASTORIA MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-274-2600
Mailing Address - Street 1:2535 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-3607
Mailing Address - Country:US
Mailing Address - Phone:718-274-2600
Mailing Address - Fax:718-274-5337
Practice Address - Street 1:2535 31ST AVE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-3607
Practice Address - Country:US
Practice Address - Phone:718-274-2600
Practice Address - Fax:718-274-5337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209191207Q00000X
NY239681207R00000X
NY162464207R00000X
NY167446207R00000X
NY207431207R00000X
NY237936207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTAX ID #