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Organization
MASPETH ROURA MEDICAL CARE PC
Active
Organization
MASPETH ROURA MEDICAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE LUIS MARTINEZ-ROURA MD (MEDICAL DIRECTOR)
(718) 507-2077
Entity
Organization
Contact information
Practice address
7215 GRAND AVE UNIT A, MASPETH, NY 11378-1525
(718) 507-2077
Mailing address
7215 GRAND AVE UNIT A, MASPETH, NY 11378-1525
(718) 507-2077
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
180117
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180117
LISCENSE
NY
Enumeration date
10/01/2007
Last updated
10/01/2007
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