Individual
AFSHIN GHOLOMHASSANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
230 BEACH 102ND ST, ROCKAWAY PARK, NY 11694-2871
(718) 634-7000
(718) 634-7600
Mailing address
3778 ILLONA LN, OCEANSIDE, NY 11572-5973
(718) 634-7000
(718) 634-7600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
218325-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02045687
—
NY
Enumeration date
05/23/2006
Last updated
07/08/2007
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