# HOLLIS HILLS MEDICAL PC

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

## Provider details

- **NPI number:** 1750566584
- **Authorized official:** DR. ROXANA RUIZCARO-CHAVEZ MD (ASSOCIATE DIRECTOR)
- **Authorized official phone:** (718) 217-2705

## Contact information

- **Practice address:** 21715 PECK AVE, QUEENS VILLAGE, NY 11427-1117
- **Practice address phone:** (718) 217-2705
- **Practice address fax:** (718) 217-2708
- **Mailing address:** 21715 PECK AVE, QUEENS VILLAGE, NY 11427-1117
- **Mailing address phone:** (718) 217-2705
- **Mailing address fax:** (718) 217-2708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 222374 | NY | Yes |

## Other

- **Enumeration date:** 12/28/2007
- **Last updated:** 12/28/2007