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Organization
JACKSON HEIGHTS LATIN MEDICAL GROUP PC
Active
Organization
JACKSON HEIGHTS LATIN MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME F ROMAN M.D. (PHYSICIAN)
(718) 803-2700
Entity
Organization
Contact information
Practice address
9315 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-7943
(718) 803-2700
(718) 803-2711
Mailing address
9315 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-7943
(718) 803-2700
(718) 803-2711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
152166
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00829790
—
NY
05
—
009244384
—
NY
Enumeration date
06/08/2009
Last updated
11/02/2009
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