# ELVIS ALFONSO MD OB-GYN PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720469356
- **Authorized official:** ELVIS M ALFONSO M.D. (DOCTOR)
- **Authorized official phone:** (321) 289-9287

## Contact information

- **Practice address:** 9001 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-7938
- **Practice address phone:** (929) 522-0165
- **Practice address fax:** (929) 522-0164
- **Mailing address:** 9001 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372-7938
- **Mailing address phone:** (929) 522-0165
- **Mailing address fax:** (929) 522-0164

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 268246 | NY | Yes |

## Other

- **Enumeration date:** 06/09/2015
- **Last updated:** 06/09/2015