Rockaway Hd Llc

NPI 1194085662 - Clinic/Center - 261QE0700X

NPI Details
NPI 1194085662
Enumeration Date 05/18/2012
Last Updated 07/17/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name OLUSEGUN OLUSEGUN
Position CEO
Phone (718) 327-7307
Fax (718) 327-3297
Practice Location
529 BEACH 20TH ST
1ST FLOOR
FAR ROCKAWAY NY, 11691-3645, US
Phone (718) 327-7307
Fax (718) 327-3297
Business Location
529 BEACH 20TH STREET
1ST FLOOR
FAR ROCKAWAY NY, 11691-3645, US
Phone (718) 327-4503
Fax (718) 327-0043
Toxanomy
Taxonomy Code 261QE0700X
License State New York
License Number 206115
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According to our database, Rockaway Hd Llc NPI is 1194085662, taxonomy code is 261QE0700X and license number is 206115, license state is located at New York. Rockaway Hd Llc physically located at 529 Beach 20th St, Far Rockaway NY, 11691-3645. NPI Number 1033115704 has the healthcare provider type.

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1194085662 NPI number is provided on an as is basis without warranty of any kind. 1194085662 is maintained by the National Plan & Provider Enumeration System. The contents of Rockaway Hd Llc are for informational purposes only.